Background: It is known that >60,000 people die of sudden cardiac death every year in japan. Among them, about 80% are caused by lifethreatening ventricular arrhythmias and a greater part of them based on ischemic cardiac disease.
Objective: The aim of this study was to investigate the significance of late potential (LP) after percutaneous coronary intervention (PCI) in acute coronary syndrome (ACS).
Method: We enrolled 220 consecutive patients (177 male, 65±12.1 y/o) with ACS admitted to our University Hospital from January to December 2012. Twenty-four hour high-resolution ambulatory electrocardiogram was performed between post-PCI procedure and hospital discharge (8±0.5 days)). The 214 analyzable patients were divided into the LP-positive (n=43) and LP-negative (n=171) groups, and the relationship between LP and major adverse cardiovascular events (MACE; cardiogenic death, myocardial infarction [MI], re-hospitalization for unstable angina and chronic heart failure) was prospectively investigated. Patient's backgrounds were investigated as below; age, gender, coronary risk of hypertension / dyslipidemia / diabetes, past history of old MI and arrhythmia, additional medicine, brain natriuretic peptide and creatine phosphokinase on arrival, ejection fraction, culprit lesion, reperfusion time, and hospital days, creatinine and glomerular filtration rate.
Results: There were no significance of patient's background in 14 variables except serum creatinine and glomerular filtration rate (GFR) on arrival. Proportion of MACE was 30.2% in the LP-positive group and 11.7% in the LP-negative group (p<0.01; by the Chi square test), and different between groups by the Kaplan-Maier analysis (p=0.01; 572±40.6 days). In the multivariable analysis with following variables (ejection fraction, creatine phosphokinase, creatinine and GFR), the odds ratio of positive LP for MACE was 3.3 (95% confidence interval, 1.4–7.6; p<0.01).
Conclusion: Assessment of LP in ACS patients with PCI treatment may useful to predict the possible occurrence of MACE.