Impact of systemic acidosis on the development of malignant ventricular arrhythmias after reperfusion therapy for ST-elevation myocardial infarction

Toshiyuki Nagai, Toshihisa Anzai, Hidehiro Kaneko, Atsushi Anzai, Yoshinori Mano, Yuji Nagatomo, Shun Kosaka, Yuichiro Maekawa, Akio Kawamura, Tsutomu Yoshikawa, Satoshi Ogawa

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background: The aim of the present study was to examine the effect of systemic acidosis on the development of malignant ventricular arrhythmias, including sustained ventricular tachycardia and ventricular fibrillation (VT/VF), after reperfused ST-elevation myocardial infarction (STEMI). Methods and Results: A total of 157 consecutive patients with a reperfused STEMI were examined. Patients were divided into 2 groups according to the presence or absence of systemic acidosis, defined as arterial blood pH <7.40 on admission. Serum creatine kinase and C-reactive protein (CRP) levels were serially measured. Systemic acidosis was observed in 53 patients (34%). There was no significant difference in coronary risk factors and arrival time from onset between the 2 groups. Estimated glomerular filtration rate (eGFR) on admission was lower in patients with acidosis than in those without (P=0.001). Patients with acidosis had a higher incidence of VT/VF (26% vs 4%, P<0.0001), especially within 48 h after STEMI (23% vs 3%, P=0.0002), than those without. The peripheral white blood cell count on admission was higher in patients with than in those without acidosis. Multivariate analysis showed that systemic acidosis was a strong independent predictor of VT/VF (relative risk =8.79, P=0.002) among variables including prior MI and eGFR <60 ml·min-1·1.73 m-2. Conclusions: Systemic acidosis was a significant determinant of VT/VF after reperfused STEMI and was associated with elevated serum CRP level. Systemic acidosis and subsequent inflammation after ischemia reperfusion may play an important role in the development of VT/VF.

Original languageEnglish
Pages (from-to)1808-1814
Number of pages7
JournalCirculation Journal
Volume74
Issue number9
DOIs
Publication statusPublished - 2010

Fingerprint

Acidosis
Reperfusion
Cardiac Arrhythmias
Ventricular Fibrillation
Ventricular Tachycardia
Therapeutics
Glomerular Filtration Rate
C-Reactive Protein
ST Elevation Myocardial Infarction
Creatine Kinase
Leukocyte Count
Blood Proteins
Multivariate Analysis
Ischemia
Inflammation
Incidence
Serum

Keywords

  • Acute myocardial infarction
  • Inflammation
  • Systemic acidosis
  • Ventricular arrhythmia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Impact of systemic acidosis on the development of malignant ventricular arrhythmias after reperfusion therapy for ST-elevation myocardial infarction. / Nagai, Toshiyuki; Anzai, Toshihisa; Kaneko, Hidehiro; Anzai, Atsushi; Mano, Yoshinori; Nagatomo, Yuji; Kosaka, Shun; Maekawa, Yuichiro; Kawamura, Akio; Yoshikawa, Tsutomu; Ogawa, Satoshi.

In: Circulation Journal, Vol. 74, No. 9, 2010, p. 1808-1814.

Research output: Contribution to journalArticle

Nagai, Toshiyuki ; Anzai, Toshihisa ; Kaneko, Hidehiro ; Anzai, Atsushi ; Mano, Yoshinori ; Nagatomo, Yuji ; Kosaka, Shun ; Maekawa, Yuichiro ; Kawamura, Akio ; Yoshikawa, Tsutomu ; Ogawa, Satoshi. / Impact of systemic acidosis on the development of malignant ventricular arrhythmias after reperfusion therapy for ST-elevation myocardial infarction. In: Circulation Journal. 2010 ; Vol. 74, No. 9. pp. 1808-1814.
@article{73b27a11da9b4a61bcca5ca9b33b01c4,
title = "Impact of systemic acidosis on the development of malignant ventricular arrhythmias after reperfusion therapy for ST-elevation myocardial infarction",
abstract = "Background: The aim of the present study was to examine the effect of systemic acidosis on the development of malignant ventricular arrhythmias, including sustained ventricular tachycardia and ventricular fibrillation (VT/VF), after reperfused ST-elevation myocardial infarction (STEMI). Methods and Results: A total of 157 consecutive patients with a reperfused STEMI were examined. Patients were divided into 2 groups according to the presence or absence of systemic acidosis, defined as arterial blood pH <7.40 on admission. Serum creatine kinase and C-reactive protein (CRP) levels were serially measured. Systemic acidosis was observed in 53 patients (34{\%}). There was no significant difference in coronary risk factors and arrival time from onset between the 2 groups. Estimated glomerular filtration rate (eGFR) on admission was lower in patients with acidosis than in those without (P=0.001). Patients with acidosis had a higher incidence of VT/VF (26{\%} vs 4{\%}, P<0.0001), especially within 48 h after STEMI (23{\%} vs 3{\%}, P=0.0002), than those without. The peripheral white blood cell count on admission was higher in patients with than in those without acidosis. Multivariate analysis showed that systemic acidosis was a strong independent predictor of VT/VF (relative risk =8.79, P=0.002) among variables including prior MI and eGFR <60 ml·min-1·1.73 m-2. Conclusions: Systemic acidosis was a significant determinant of VT/VF after reperfused STEMI and was associated with elevated serum CRP level. Systemic acidosis and subsequent inflammation after ischemia reperfusion may play an important role in the development of VT/VF.",
keywords = "Acute myocardial infarction, Inflammation, Systemic acidosis, Ventricular arrhythmia",
author = "Toshiyuki Nagai and Toshihisa Anzai and Hidehiro Kaneko and Atsushi Anzai and Yoshinori Mano and Yuji Nagatomo and Shun Kosaka and Yuichiro Maekawa and Akio Kawamura and Tsutomu Yoshikawa and Satoshi Ogawa",
year = "2010",
doi = "10.1253/circj.CJ-10-0229",
language = "English",
volume = "74",
pages = "1808--1814",
journal = "Circulation Journal",
issn = "1346-9843",
publisher = "Japanese Circulation Society",
number = "9",

}

TY - JOUR

T1 - Impact of systemic acidosis on the development of malignant ventricular arrhythmias after reperfusion therapy for ST-elevation myocardial infarction

AU - Nagai, Toshiyuki

AU - Anzai, Toshihisa

AU - Kaneko, Hidehiro

AU - Anzai, Atsushi

AU - Mano, Yoshinori

AU - Nagatomo, Yuji

AU - Kosaka, Shun

AU - Maekawa, Yuichiro

AU - Kawamura, Akio

AU - Yoshikawa, Tsutomu

AU - Ogawa, Satoshi

PY - 2010

Y1 - 2010

N2 - Background: The aim of the present study was to examine the effect of systemic acidosis on the development of malignant ventricular arrhythmias, including sustained ventricular tachycardia and ventricular fibrillation (VT/VF), after reperfused ST-elevation myocardial infarction (STEMI). Methods and Results: A total of 157 consecutive patients with a reperfused STEMI were examined. Patients were divided into 2 groups according to the presence or absence of systemic acidosis, defined as arterial blood pH <7.40 on admission. Serum creatine kinase and C-reactive protein (CRP) levels were serially measured. Systemic acidosis was observed in 53 patients (34%). There was no significant difference in coronary risk factors and arrival time from onset between the 2 groups. Estimated glomerular filtration rate (eGFR) on admission was lower in patients with acidosis than in those without (P=0.001). Patients with acidosis had a higher incidence of VT/VF (26% vs 4%, P<0.0001), especially within 48 h after STEMI (23% vs 3%, P=0.0002), than those without. The peripheral white blood cell count on admission was higher in patients with than in those without acidosis. Multivariate analysis showed that systemic acidosis was a strong independent predictor of VT/VF (relative risk =8.79, P=0.002) among variables including prior MI and eGFR <60 ml·min-1·1.73 m-2. Conclusions: Systemic acidosis was a significant determinant of VT/VF after reperfused STEMI and was associated with elevated serum CRP level. Systemic acidosis and subsequent inflammation after ischemia reperfusion may play an important role in the development of VT/VF.

AB - Background: The aim of the present study was to examine the effect of systemic acidosis on the development of malignant ventricular arrhythmias, including sustained ventricular tachycardia and ventricular fibrillation (VT/VF), after reperfused ST-elevation myocardial infarction (STEMI). Methods and Results: A total of 157 consecutive patients with a reperfused STEMI were examined. Patients were divided into 2 groups according to the presence or absence of systemic acidosis, defined as arterial blood pH <7.40 on admission. Serum creatine kinase and C-reactive protein (CRP) levels were serially measured. Systemic acidosis was observed in 53 patients (34%). There was no significant difference in coronary risk factors and arrival time from onset between the 2 groups. Estimated glomerular filtration rate (eGFR) on admission was lower in patients with acidosis than in those without (P=0.001). Patients with acidosis had a higher incidence of VT/VF (26% vs 4%, P<0.0001), especially within 48 h after STEMI (23% vs 3%, P=0.0002), than those without. The peripheral white blood cell count on admission was higher in patients with than in those without acidosis. Multivariate analysis showed that systemic acidosis was a strong independent predictor of VT/VF (relative risk =8.79, P=0.002) among variables including prior MI and eGFR <60 ml·min-1·1.73 m-2. Conclusions: Systemic acidosis was a significant determinant of VT/VF after reperfused STEMI and was associated with elevated serum CRP level. Systemic acidosis and subsequent inflammation after ischemia reperfusion may play an important role in the development of VT/VF.

KW - Acute myocardial infarction

KW - Inflammation

KW - Systemic acidosis

KW - Ventricular arrhythmia

UR - http://www.scopus.com/inward/record.url?scp=77956109600&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77956109600&partnerID=8YFLogxK

U2 - 10.1253/circj.CJ-10-0229

DO - 10.1253/circj.CJ-10-0229

M3 - Article

VL - 74

SP - 1808

EP - 1814

JO - Circulation Journal

JF - Circulation Journal

SN - 1346-9843

IS - 9

ER -