Original article Impact of Acute Coronary Syndrome Complicated by Ventricular Fibrillation on Long-term Incidence of Sudden Cardiac Death Bele ´n A ´ lvarez-A ´ lvarez,* Noelia Bouzas-Cruz, Emad Abu-Assi, Sergio Raposeiras-Roubin, Andrea Lo ´ pez-Lo ´ pez, Marı ´a Cristina Gonza ´ lez Cambeiro, Carlos Pen ˜ a-Gil, Jose ´ Marı ´a Garcı ´a-Acun ˜a, and Jose ´ Ramo ´n Gonza ´ lez-Juanatey Servicio de Cardiologı´a y Unidad Coronaria, Hospital Clı´nico Universitario de Santiago de Compostela, Santiago de Compostela, A Corun ˜a, Spain Rev Esp Cardiol. 2015;68(10):878–884 Article history: Received 4 August 2014 Accepted 3 November 2014 Available online 21 March 2015 Keywords: Ventricular fibrillation Acute coronary syndrome Sudden death A B S T R A C T Introduction and objectives: There is little information on the effect of acute coronary syndrome complicated by ventricular fibrillation on the long-term incidence of sudden cardiac death. We analyzed this effect in a contemporary cohort of patients with acute coronary syndrome. Methods: We studied 5302 consecutive patients with acute coronary syndrome between December 2003 and December 2012. We compared mortality during and after hospitalization according to the presence or absence of ventricular fibrillation. Results: Ventricular fibrillation was observed in 163 (3.1%) patients, and was early onset in 72.4% of these patients. In-hospital mortality was 36.2% in the group with ventricular fibrillation and 4.7% in the group without (p < .001). After a mean follow-up of 4.7 years (standard deviation, 2.6 years), mortality was 30.7% in the ventricular fibrillation group and 24.7% in the other group (P = .23). After adjusting for confounding variables, the presence of ventricular fibrillation was not associated with an increased risk of death in the follow-up period (hazard ratio = 1.29; 95% confidence interval, 0.90-1.87). The cause of death was established in 72% of patients. The incidence of sudden death was 12.9% in the ventricular fibrillation group and 11.9% in the other group (P = .71). Cardiovascular-cause mortality was also similar between the 2 groups (35.5% and 34.4%, respectively. Conclusions: Patients with acute coronary syndrome complicated by ventricular fibrillation who survive the in-hospital phase do not appear to be at an increased risk of sudden cardiac death or other cardiovascular-cause death. ß 2014 Sociedad Espan ˜ola de Cardiologı ´a. Published by Elsevier Espan ˜a, S.L.U. All rights reserved. Impacto de la fibrilacio ´n ventricular que complica el curso de un sı ´ndrome coronario agudo en la incidencia a largo plazo de muerte su ´ bita cardiaca Palabras clave: Fibrilacio ´n ventricular Sı ´ndrome coronario agudo Muerte su ´ bita R E S U M E N Introduccio ´n y objetivos: Existe escasa informacio ´n sobre el efecto de la fibrilacio ´n ventricular que complica un sı ´ndrome coronario agudo en la incidencia a largo plazo de muerte su ´ bita cardiaca. Se analiza dicho efecto en una cohorte contempora ´ nea de pacientes con sı ´ndrome coronario agudo. Me ´todos: Entre diciembre de 2003 y diciembre de 2012, se estudio ´a 5.302 pacientes consecutivos con sı ´ndrome coronario agudo. Se comparo ´ la mortalidad hospitalaria y tras el alta por grupos segu ´n la presencia o ausencia de fibrilacio ´n ventricular. Resultados: Tenı ´an fibrilacio ´n ventricular 163 (3,1%) pacientes; en el 72,4% se trataba de fibrilacio ´n ventricular precoz. La mortalidad hospitalaria fue el 36,2% del grupo con fibrilacio ´n ventricular y el 4,7% del grupo sin fibrilacio ´n ventricular (p < 0,001). La mortalidad tras 4,7  2,6 an ˜os del alta fue el 30,7% del grupo con fibrilacio ´n ventricular y el 24,7% del otro grupo (p = 0,23). La presencia de fibrilacio ´n ventricular no se asocio ´, tras ajustar por varias variables confusoras, a un incremento del riesgo de muerte (hazard ratio = 1,29; intervalo de confianza del 95%, 0,90-1,87). Se pudo determinar la causa de la muerte del 72% de los pacientes: la incidencia de muerte su ´ bita fue del 12,9% del grupo de fibrilacio ´n ventricular y el 11,9% del otro grupo (p = 0,71); la mortalidad por causa cardiovascular fue similar: el 35,5 y el 34,4% respectivamente. * Corresponding author: Servicio de Cardiologı ´a y Unidad Coronaria, Hospital Clı ´nico Universitario de Santiago de Compostela, A Choupana s/n, 15706 Santiago de Compostela, A Corun ˜a, Spain. E-mail addresses: belenalvarezalvarez85@gmail.com, noeliabouzas@gmail.com (B. A ´ lvarez-A ´ lvarez). http://dx.doi.org/10.1016/j.rec.2014.11.015 1885-5857/ß 2014 Sociedad Espan ˜ ola de Cardiologı ´a. Published by Elsevier Espan ˜a, S.L.U. All rights reserved. Document downloaded from https://www.revespcardiol.org/, day 05/12/2021. This copy is for personal use. Any transmission of this document by any media or format is strictly prohibited. Document downloaded from https://www.revespcardiol.org/, day 05/12/2021. This copy is for personal use. Any transmission of this document by any media or format is strictly prohibited.