(Ivanhoe Newswire) – 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