Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
11
pubmed:dateCreated
2008-11-25
pubmed:abstractText
Sustained ventricular arrhythmias and heart failure are well-recognized complications after acute myocardial infarction (AMI) and have been associated with worse outcomes and increased mortality. The use of and outcomes associated with acute beta-blocker therapy in patients with AMI complicated by sustained ventricular tachycardia (VT) or ventricular fibrillation (VF) and heart failure were investigated. Of 5,391 patients in the VALIANT Registry, sustained VT/VF occurred in 306 (5.7%), with an in-hospital mortality rate of 20.3%. Multivariable logistic regression identified sustained VT/VF as a major predictor of in-hospital death (relative risk 4.18, 95% confidence interval 2.91 to 5.93). Of those with sustained VT/VF, 55.2% were treated with intravenous or oral beta blockade in the first 24 hours. After adjusting for baseline characteristics, propensity for acute beta-blocker use, and the interaction between Killip classification and beta-blocker therapy, beta-blocker therapy within 24 hours was associated with decreased in-hospital mortality in patients with sustained VT/VF (relative risk 0.28, 95% confidence interval 0.10 to 0.75, p = 0.013) without evidence of worsening heart failure. Patients with sustained VT/VF were less likely to receive beta blockers within 24 hours (p = 0.001). In conclusion, sustained VT/VF was common after AMI. In patients with sustained VT/VF, beta-blocker therapy in the first 24 hours after AMI was associated with decreased early mortality without worsening heart failure. Unfortunately, beta blockers were underused acutely in patients with sustained VT/VF.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
AIM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Dec
pubmed:issn
1879-1913
pubmed:author
pubmed:issnType
Electronic
pubmed:day
1
pubmed:volume
102
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
1427-32
pubmed:meshHeading
pubmed-meshheading:19026290-Adrenergic beta-Antagonists, pubmed-meshheading:19026290-Aged, pubmed-meshheading:19026290-Clinical Trials as Topic, pubmed-meshheading:19026290-Death, Sudden, Cardiac, pubmed-meshheading:19026290-Drug Prescriptions, pubmed-meshheading:19026290-Female, pubmed-meshheading:19026290-Hospital Mortality, pubmed-meshheading:19026290-Humans, pubmed-meshheading:19026290-Incidence, pubmed-meshheading:19026290-Logistic Models, pubmed-meshheading:19026290-Male, pubmed-meshheading:19026290-Middle Aged, pubmed-meshheading:19026290-Multivariate Analysis, pubmed-meshheading:19026290-Myocardial Infarction, pubmed-meshheading:19026290-Physician's Practice Patterns, pubmed-meshheading:19026290-Registries, pubmed-meshheading:19026290-Retrospective Studies, pubmed-meshheading:19026290-Risk Assessment, pubmed-meshheading:19026290-Risk Factors, pubmed-meshheading:19026290-Tachycardia, Ventricular, pubmed-meshheading:19026290-Time Factors, pubmed-meshheading:19026290-Ventricular Fibrillation
pubmed:year
2008
pubmed:articleTitle
Relation of mortality to failure to prescribe beta blockers acutely in patients with sustained ventricular tachycardia and ventricular fibrillation following acute myocardial infarction (from the VALsartan In Acute myocardial iNfarcTion trial [VALIANT] Registry).
pubmed:affiliation
Division of Cardiology, Department of Medicine, and Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA. jonathan.piccini@duke.edu
pubmed:publicationType
Journal Article, Research Support, Non-U.S. Gov't