AbstractObjective: The study aimed to evaluate clinical and angiographic profile of Asian Indians presenting withsustained ventricular tachycardia (VT) in STEMI to derive predictors of in hospital mortality and outcomes. Methods: This was a prospective, open label, all comersstudy of 200 consecutive patients who presented with sustained VT in the setting of STEMI in a tertiary care center of western India from January 2016 to December 2018.Clinical and the angiographic profile of all patients were analyzed and correlated with outcomes especially with in hospital mortality.
Results: Of 200 patients, 156(78%) were male and 44(22%) were female. Mean age of patients was 55.63±11.68years.Among the traditional risk factors, smoking and hypertension (63% and 63.5%) was the most prevalent and had the highest odds ratio of 1.41(95% CI 0.61 to 3.26; P 0.42 and 2.67 (95% CI 1.04 to 6.87; P0.04) consecutively. 48.5% of the patients had LAD as culprit artery, 38.5% of the patients had RCA as culprit artery. Hence Non- LCX culprit vessel had an OR of 1.41(95% CI 0.40 to 5.02; P 0.6).79% patients were hemodynamically unstable1.51(95% CI 0.62 to 3.7; P 0.37)at the time of VT, 21% patients were hemodynamically stable. In hospital mortality was 15% (30/200) and all these patients hadhemodynamically unstable at VT (p value< 0.0001).Prolonged QTc interval was significantly (p value <0.001) higher in mortality patients (470.13±36.76 msec) ascompared to the discharged patients(444.53±18.58 msec) with OR of 2.16(95% CI 0.83 to 0.98; P <0.0001)
Conclusion: The predictors of in hospital mortality due to VT in STEMI amongst Asian Indians were smoking and hypertension with lowest OR 0.69 and 0.37.Hemodynamically unstable VT, non-LCX culprit vessel and prolonged QTc with highest OR 2.16 for prolonged QTc.