May 11, 2009
Heart Complication Ups Mortality Rate
People with a certain type of heart condition are more likely to die following coronary angioplasty or stent placement if they suffer from an irregular heart rhythm before or after the procedure.
According to doctors from the Duke Clinical Research Institute, the irregular heart rhythm "“ called sustained ventricular tachycardia or fibrillation, or VT/VF "“ occurred in 5.7 percent of the 5,745 patients with ST elevation myocardial infarction (STEMI) they studied. These patients had about a 23 percent death rate by 90 days post-procedure. The death rate was under 4 percent for patients without VT/VF.
Timing of the VT/VF made a big difference. For those whose irregular heart rhythm occurred prior to the procedure, the death rate was about 17 percent. For those who experienced the condition following the procedure the death rate was about 33 percent.
After adjusting the findings to take other factors into account, researchers found the risk of death was more than three times higher for patients with VT/VF. For those with early VT/VF, it was more than two times higher, and for those with late VT/VF it was more than five times higher.
People with early VT/VF tended to have lower systolic blood pressure, higher body weight, and higher heart rate. Lower systolic blood pressure and higher heart rate were also seen in people with late VT/VF, and these people were also less likely to have received beta-blockers on admission to the hospital.
The investigators believe these findings call for closer monitoring of STEMI patients undergoing coronary angioplasty or stent placement.
SOURCE: The Journal of the American Medical Association, published online May 5, 2009