| Summary: | 碩士 === 臺北醫學大學 === 傷害防治學研究所 === 97 === Objective：To analyze the factors that predispose the occurrence of ventricular arrhythmia (VA) in young patients with a first acute myocardial infarction (AMI) in the emergency department (ED) and to establish predictive implications.
Methods：This is a 10-year retrospective cohort study. Patients who wereolder than 18 years and younger than 45 years with a first attack of AMI were recruited from the ED of three universityteaching hospitals from January 1, 1998, to December 31,2007.
Results：Five hundred young patients (472 men and 28 women) who met the inclusion criteria were enrolled. Within these patients, theincidence of life-threatening VA with first attack of AMI was 8% (n=40). They were categorized into 2 groups: VA attack (n =40) and non-VA attack (n = 460). In univariable analyses, acute anterolateral ST-segment elevation myocardial infarction (65% vs 47.8%, p=0.04), elevate white blood cell (WBC) count (16.4±3.4 vs 11.5±3.1 x 103 per mm3, p<0.01), and initial serum glucose level (202.6±90.9 vs 151.9±64.7 mg/dL, p<0.01) were significantly increased in VA group. Multiple logistic regression model identified WBC count, and initial serum glucose level as the significant independent variables in the prediction of VA attack for young patients with first attack of AMI. The receiver operating characteristic area for WBC count and serum glucose level in predicting the risk of VA occurred
after AMI was 0.869 and 0.756, respectively.
Conclusion：Initial serum glucose level and WBC may be used as valuable predictors for VA attack in young patients with
first AMI.
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