S.QUEK1, IKK CHUNG1
Tan Tock Seng Hospital1
Current data on arrhythmic risks after acute myocardial infarction in the modern era of early revascularization in the Asian population are limited.
The purpose of this study was to investigate the incidence of arrhythmic risks after acute ST elevation myocardial infarction in a contemporary cohort of Chinese patients in the era of early revascularization.
A cohort of 394 patients admitted with ST elevation myocardial infarction who under emergency revascularization were studied. Mean age 59.76 ± 12.84 years old, male 88%, diabetes mellitus 40%, hypertension 72%, hyperlipidaemia 78%, previous ischaemic heart disease or stroke 10%, smoker 65%. The mean follow up period was of 577 ± 118 days and the mean pain to needle time (onset of chest pain to primary angioplasty) was 4.88 ± 4.60 hours. The mean left ventricular ejection fraction (LVEF) was 41.98 ± 10.79% and 130 patients had LVEF ≤35%.
There were a total of 12 deaths recorded during the period of follow up. 8 from non-arrhythmic causes, 1 cardiac arrest due to ventricular fibrillation and 3 deaths of unknown cause. The risk of arrhythmic death and death of unknown cause was found to be 0.64% per year. 15 patients developed atrial fibrillation and the risk of atrial fibrillation is 2.4% per year. The mean LVEF 29.74 ± 5.95% showed a significant improvement to 39.85 ± 10.13% (p<0.001) after 6 months post revascularization.
The arrhythmic risks after acute myocardial infarction in the modern era of early revascularization in the Asian population is lower than previously reported.