Clinical InvestigationAcute Ischemic Heart DiseaseVentricular arrhythmias after acute myocardial infarction: A 20-year community study
Section snippets
Study setting
This study was conducted with approval from the medical center's institutional review board. The characteristics of the region's population (a county in the upper Midwest) are similar to those of the US white population. Epidemiological studies are possible because the county is relatively isolated, and a few providers deliver nearly all health care to local residents. Each medical provider uses a comprehensive medical record system in which the details of every encounter are entered and can be
Characteristics of the MI cohort
Between 1979 and 1998, 2317 persons (43% women, mean age 67.4 ± 14.3 years) were hospitalized with incident MI (Table I). Risk factors were prevalent, with hypertension and smoking present in more than half the cohort. Twenty percent of subjects had diabetes, and the mean body mass index was 27.1 ± 5.8 kg/m2. Most patients (65%) were in Killip class I, and 16% of patients were treated with β-blockers before admission. Forty-three percent of the cohort members had ST-elevation MI (STEMI) and 57%
Discussion
In this geographically defined cohort, 7% of patients developed VA after incident MI, occurring mostly within the first 48 hours. Over time, the occurrence of all VA declined slightly because of a relative shift in the distribution of the types of VA. Although the incidence of nonprimary VF decreased, that of primary VF and VT remained stable. Characteristics associated with the occurrence of VA include younger age, female sex, AF, STEMI, and higher Killip class and the inaugural nature of the
Conclusions
In this geographically defined MI incidence cohort, 7% of patients developed VA after incident MI, occurring mostly within the first 48 hours. During the 2 decades studied, the occurrence of VA after MI declined slightly, with a relative shift in the respective distribution of the types of VA. Ventricular arrhythmias were more likely to occur among individuals without a history of cardiac disease and with a higher Killip class. All VAs, including primary VF, are associated with a marked
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This study was supported in part by grants AR30582 and HL59205 from the Public Health Service and the National Institutes of Health. Dr Roger is an established investigator of the American Heart Association.