Cardiac disease and prognosis associated with ventricular tachyarrhythmias in young adults and adults

Kathrin Weidner, Michael Behnes, Tobias Schupp, Jorge Hoppner, Ibrahim El-Battrawy, Uzair Ansari, Ahmad Saleh, Gabriel Taton, Linda Reiser, Armin Bollow, Thomas Reichelt, Dominik Ellguth, Niko Engelke, Thomas Bertsch, Dirk Große Meininghaus, Ursula Hoffmann, Ibrahim Akin, Kathrin Weidner, Michael Behnes, Tobias Schupp, Jorge Hoppner, Ibrahim El-Battrawy, Uzair Ansari, Ahmad Saleh, Gabriel Taton, Linda Reiser, Armin Bollow, Thomas Reichelt, Dominik Ellguth, Niko Engelke, Thomas Bertsch, Dirk Große Meininghaus, Ursula Hoffmann, Ibrahim Akin

Abstract

Background: This study evaluates cardiac diseases and prognosis in young adults and adults presenting with ventricular tachyarrhythmias (VTA).

Methods: The present longitudinal, observational, registry-based, monocentric cohort study includes all consecutive patients 45 years old or younger presenting with VTA at admission from 2002 to 2016. Rates of coronary angiography, coronary artery disease (CAD) and need for percutaneous coronary intervention (PCI), cardiac diseases associated with VTA, and differences in long-term prognostic endpoints for young adults (20-34 years old) were analyzed and compared to those of adults (35-45 years old), for whom multivariable risk prediction models were developed. Kaplan-Meier analyses were performed according to age and type of VTA.

Results: A total of 259 consecutive patients were included in the study (36% young adults and 64% adults). At admission, 38% of young adults had VTA due to CAD that required PCI. Furthermore, VTA in young adults was commonly idiopathic (27%), or had underlying channelopathies (18%), primary cardiomyopathies (13%) or acute myocardial infarction (AMI, 11%). In adults, VTA was mostly associated with AMI (28%), though the rate of idiopathy was still high (20%). A total 41% of all patients received cardiopulmonary resuscitation (CPR), for whom AMI (STEMI 17%, NSTEMI 24%) was most frequently observed. Irrespective of the type of VTA, all-cause mortality was similar for young adults and adults. In young adults, left ventricular ejection fraction (LVEF) < 35% (HR = 33.590) was associated with increased long-term all-cause mortality.

Conclusion: Despite high rates of idiopathic ventricular tachyarrhythmias, CAD and AMI are common causes of VTA and CPR in adults 45 years old and younger. Young adults and adults had comparable survival at index hospitalization and after 2.5 years irrespective of the type of VTA. Clinical trial registration clinicaltrials.gov identifier: NCT02982473.

Keywords: Age; Cardiac-related disease; Cardiovascular risk factors; Coronary artery disease; Long-term mortality; Ventricular tachyarrhythmia; Young adults.

Conflict of interest statement

The authors declare no competing interests.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
Bar diagram depicting coronary angiography rates, relevant CAD, and need for PCI according to age
Fig. 2
Fig. 2
Cardiac diseases underlying VTA in young adults (left chart) and adults (right chart)
Fig. 3
Fig. 3
Cardiac diseases in patients who received CPR due to VTA at index hospitalization
Fig. 4
Fig. 4
Kaplan–Meier analysis for the primary endpoint of all-cause mortality at 2.5 years and the composite arrhythmic endpoint in patients with ventricular fibrillation and sustained VT (panel I and III) and in patients with non-sustained VT (panel II and IV)

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Source: PubMed

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