| Autor: |
Valentina, Faga, Ignasi, Anguera, Teresa, Oloriz, Luis, Nombela-Franco, Luis, Teruel, Paolo, Dallaglio, Ainhoa, Perez Guerrero, Carlos, Hernando Salazar, Javier, Escaned, Antonio, Asso Abadía, Joan Antoni, Gomez Hospital, Julián, Rodriguez García, Marcos, Rodriguez García, Josep, Comin Colet, Andrea, Di Marco |
| Rok vydání: |
2022 |
| Předmět: |
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| Zdroj: |
International Journal of Cardiology. 355:9-14 |
| ISSN: |
0167-5273 |
| Popis: |
To evaluate predictors of electrical storm (ES), including chronic total occlusion in an infarct-related coronary artery (infarct-related artery CTO, IRACTO), in a cohort of patients with prior myocardial infarction (MI) and implantable cardioverter-defibrillators (ICD).Multicenter observational cohort study including 643 consecutive patients with prior MI and a first ICD implanted between 2005 and 2018 at three tertiary hospitals. All the patients included in the study had undergone a diagnostic coronary angiography before ICD implantation. The variable prior ventricular arrhythmias (VA+) was positive in patients with secondary prevention ICDs and in those with at least one appropriate ICD therapy after primary prevention implantation.During a median follow-up of 42 months 59 patients (9%) suffered ES. The presence of at least one IRACTO not revascularized (IRACTO-NR) was associated with a significantly higher cumulative incidence of ES (14.5% vs 4.8%, p 0.001). IRACTO-NR maintained a significant association with ES after adjustment for potential confounders (HR 2.3, p = 0.005) and was an independent predictor of ES together with VA+ and LVEF. The best cut-off of LVEF to predict ES was ≤38%. A risk-prediction model based on IRACTO-NR, VA+ and LVEF≤38% identified three categories of ES risk (low, intermediate and high), with progressively increasing cumulative incidence of ES (2.2%, 9% and 20%).In a cohort of patients with prior MI and ICD, IRACTO-NR is an independent predictor of ES. A new risk-prediction model allowed the identification of three categories of risk, with potentially important clinical implications. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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Full Text from ScienceDirect