C2 DIFFERENT CLINICAL PREDICTORS OF EARLY AND LATE PRIMARY VENTRICULAR FIBRILLATION: RESULTS OF THE PREDESTINATION STUDY

Abstract Introduction Few studies evaluated risk factors for primary ventricular fibrillation (VF) before reperfusion during a first acute myocardial infarction (AMI). Important parameters such as kalemia, blood pressure (BP) and heart rate (HR) at presentation were rarely considered. Furthermore, potential differences according to the time elapsed between symptoms onset VF have never been investigated. Objectives evaluate predictors of in PREDESTINATION (PRImary vEntricular suDden dEath firST myocardIal iNfArcTION) study cohort also differentiating early (<60 min from onset) late (>60 min) VF. Early is more likely cause sudden death (SD) medical services arrival. Patients Methods prospective, multicenter, case–control (1:2 age– sex–matched) enrolling patients aged 18–80 years with AMI, either complicated (cases) or not (controls) by reperfusion. Results 1478 analysed: mean age was 59 years, 83% male, 36% cases. The multivariate analysis (logistic regression) on whole population (c–statistic= 0.74) identified 8 independent VF: atrial presenting rhythm (OR 4.61), kalemia ≤3.5 mEq/L 2.8), HR ≥90 bpm 2.25), first–degree family history SD 2.08), anterior infarct site 1.54), physical inactivity 1.59), systolic BP 0.98 each mmHg), coronary artery disease/myocardial 0.71). known 405 cases (184 221 VF). There 6 VF, loss significance disease/infarction, an increase OR 2.85 (95% CI: 1.6–5.08), c–statistic model 0.80. Among other hand, AMI confirmed (c–statistic 0.7). Conclusions present First–degree powerful predictor but suggesting that genetic predisposition plays determining role only early–onset therefore advisability specific investigation these patients.