Background
The study sought to assess the prognostic impact of acute myocardial infarction (
AMI
) with and without
ST
‐segment–elevation myocardial infarction (
STEMI
and
NSTEMI
) in patients with ventricular tachyarrhythmias and sudden cardiac arrest (
SCA
) on admission.
Methods and Results
A large retrospective registry was used including all consecutive patients presenting with ventricular tachycardia (
VT
), fibrillation (
VF
), and sudden cardiac arrest (
SCA
) on admission from 2002 to 2016.
AMI
versus non‐
AMI
and
STEMI
versus
NSTEMI
were compared applying multivariable Cox regression models and propensity‐score matching for evaluation of the primary prognostic end point defined as long‐term all‐cause mortality at 2.5 years. Secondary end points were 30 days all‐cause mortality, cardiac death at 24 hours, in hospital death, and recurrent percutaneous coronary intervention (re‐
PCI
) at 2.5 years. In 2813 unmatched high‐risk patients with ventricular tachyarrhythmias and
SCA
,
AMI
was present in 29% (10%
STEMI
, 19%
NSTEMI
) with higher rates of
VF
(54% versus 31%) and
SCA
(35% versus 26%), whereas
VT
rates were higher in non‐
AMI
(56% versus 30%) (
P
< 0.05).
AMI
‐related
VT
≥48 hours was associated with higher mortality (log rank
P
= 0.001). Multivariable Cox regression models revealed non‐
AMI
(hazard ratio = 1.458;
P
= 0.001) and
NSTEMI
(hazard ratio = 1.460;
P
= 0.036) associated with increasing long‐term all‐cause mortality at 2.5 years, which was also proven after propensity‐score matching (non‐
AMI
versus
AMI
: 55% versus 43%, log rank
P
= 0.001, hazard ratio = 1.349;
NSTEMI
versus
STEMI
: 45% versus 34%, log rank
P
= 0.047, hazard ratio = 1.372). Secondary end points including 30 days and in‐hospital mortality, as well as re‐
PCI
were higher in non‐
AMI
patients.
Conclusions
In high‐risk patients presenting with ventricular tachyarrhythmias and
SCA
, non‐
AMI
revealed higher mortality tha...
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