Ventricular Arrhythmias Complicating Coronary Artery Disease: Recent Trends, Risk Associated with Serum Glucose Levels, and Psychological Impact
Authors
Tran, Hoang V.Faculty Advisor
Catarina Kiefe; Robert GoldbergAcademic Program
Clinical and Population Health ResearchUMass Chan Affiliations
Quantitative Health SciencesDocument Type
Doctoral DissertationPublication Date
2018-06-18Keywords
Ventricular tachycardiaventricular fibrillation
ventricular arrhythmia
incidence
mortality
fatality
rate
trend
depression
anxiety
acute myocardial infarction
acute coronary syndrome
hyperglycemia
glucose
Cardiology
Circulatory and Respiratory Physiology
Clinical Epidemiology
Endocrinology, Diabetes, and Metabolism
Epidemiology
Internal Medicine
Psychiatric and Mental Health
Psychiatry
Psychoanalysis and Psychotherapy
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Introduction: Ventricular arrhythmias (VAs) are common after an acute coronary syndrome (ACS) and are associated with worse clinical outcomes. However, little is known about recent trends in their occurrence, their association with serum glucose levels, and their psychological impact in ACS setting. Methods: We examined 25-year (1986-2011) trends in the incidence rates (IRs) and hospital case-fatality rates (CFRs) of VAs, and the association between serum glucose levels and VAs in patients with an acute myocardial infarction (AMI) in the Worcester Heart Attack Study. Lastly, we examined the relationship between in-hospital occurrence of VAs and 12-month progression of depression and anxiety among hospital survivors of an ACS in the longitudinal TRACE-CORE study. Results: We found the IRs declined for several major VAs between 1986 and 2011while the hospital CFRs declined in both patients with and without VAs over this period. Elevated serum glucose levels at hospital admission were associated with a higher risk of developing in-hospital VAs. Occurrence of VAs, however, was not associated with worsening progression of symptoms of depression and/or anxiety over a 12-month follow-up period in patients discharged after an ACS. Conclusions: The burden and impact of VAs in patients with an AMI has declined over time. Elevated serum glucose levels at hospital admission may serve as a predictor for in-hospital occurrence of serious cardiac arrhythmias. In-hospital occurrence of VAs may not be associated with worsening progression of symptoms of depression and anxiety in patients with an ACS.DOI
10.13028/M2NH53Permanent Link to this Item
http://hdl.handle.net/20.500.14038/32368Rights
Licensed under a Creative Commons licenseDistribution License
http://creativecommons.org/licenses/by-nc/4.0/ae974a485f413a2113503eed53cd6c53
10.13028/M2NH53
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