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首页> 外文期刊>The American Journal of Cardiology >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 (VALIAN
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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 (VALIAN

机译：急性心肌梗死后持续性室性心动过速和心室纤颤患者的死亡率与未能急性开具β受体阻滞剂的关系（来自VALsartan的急性心肌梗塞试验（VALIAN

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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.
机译：持续性室性心律失常和心力衰竭是急性心肌梗塞（AMI）后公认的并发症，与预后不良和死亡率增加相关。研究了急性β受体阻滞剂治疗并发持续性室性心动过速（VT）或室性纤颤（VF）和心力衰竭的AMI患者的使用及其相关结果。在VALIANT注册表中的5391名患者中，持续性VT / VF发生在306名（5.7％）中，院内死亡率为20.3％。多变量logistic回归确定持续的VT / VF是院内死亡的主要预测指标（相对危险度4.18，95％置信区间2.91至5.93）。在持续室速/室颤的患者中，有55.2％在开始的24小时内接受了静脉或口服β受体阻滞治疗。在调整了基线特征，急性β-受体阻滞剂的使用倾向以及Killip分类和β-受体阻滞剂之间的相互作用后，24小时内的β-受体阻滞剂治疗与持续VT / VF患者的院内死亡率降低相关（相对风险为0.28，95％置信区间为0.10至0.75，p = 0.013），而没有心力衰竭恶化的证据。持续室速/室颤患者在24小时内接受β受体阻滞剂的可能性较小（p = 0.001）。总之，AMI后持续性VT / VF很常见。对于持续VT / VF的患者，AMI后头24小时内的β受体阻滞剂治疗可降低早期死亡率，而不会使心力衰竭恶化。不幸的是，持续性VT / VF患者的β受体阻滞剂未得到充分利用。

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