• Kristel E Medina-Rodríguez, Manuel Almendro-Delia, Ángel García-Alcántara, José J Arias-Garrido, Juan C Rodríguez-Yáñez, Gemma Alonso-Muñoz, Rafael de la Chica-Ruiz-Ruano, Antonio Reina-Toral, Antonio Varela-López, José A Arboleda-Sánchez, Ana M Poullet-Brea, Benito Zaya-Ganfo, Michel Butrón-Calderón, Maria J Cristo-Ropero, Rafael Hidalgo-Urbano, Juan C García-Rubira, and Group SCA Plataforma Ariam-Andalucía.
• aDepartment of Cardiology, University Hospital Virgen Macarena, Sevilla bCritical Care Service, University Hospital Virgen de la Victoria, Málaga cCritical Care Unit, Hospital de Antequera dCritical Care Service, University Hospital Regional de Málaga eCritical Care Service, University Hospital Costa del Sol, Málaga fCritical Care Service, University Hospital Jerez gCritical Care Service, University Hospital Puerto Real, Cádiz hCritical Care Service, University Hospital Reina Sofía, Córdoba iCritical Care Service, University Hospital Virgen de las Nieves, Granada, Spain.
• Coron. Artery Dis. 2017 Nov 1; 28 (7): 570-576.

ObjectiveThe aim of this study was to analyze the prognosis of patients presenting early ventricular fibrillation (VF) in the setting of ST elevation myocardial infarction (STEMI).Patients And MethodsAmong patients included in the ARIAM (Análisis del Retraso en el Infarto Agudo de Miocardio) registry with the diagnosis of STEMI, those who received primary revascularization and were admitted in the first 12 h were analyzed retrospectively.ResultsFrom January 2007 to January 2012, 8340 patients were included in the STEMI cohort and 680 (8.2%) of them presented with VF before admission to the ICU (VF). This group comprised younger patients with fewer comorbidities. They received more often primary angioplasty (33.7 vs. 24.9%; P<0.001), had more prevalence of Killip class greater than or equal to 2 at admission (37.5 vs. 17.8%; P<0.001), and suffered more often cardiogenic shock (18.5 vs. 5.9%, P<0.001). By logistic regression analysis, VF was associated with a greater in-hospital mortality [odds rate (OR): 2.08, 95% confidence interval (CI): 1.57-2.81, P<0.001]. After a propensity score matching process, VF was associated with in-hospital mortality (OR: 1.53, 95% CI: 1.05-2.25, P=0.028). However, when analyzing patients treated by primary angioplasty, the mortality was not significantly related to VF (OR: 0.86, 95% CI: 0.45-1.61, P=0.628).ConclusionOur results show that VF before ICU admission was an independent predictor of in-hospital outcome in a cohort of patients in whom fibrinolysis was the most used revascularization therapy. However, this prognostic value was not found in patients treated with primary angioplasty.

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