Non-fatal cardiovascular events preceding sudden cardiac death in patients with an acute myocardial infarction complicated by heart failure: insights from the high-risk myocardial infarction database

• Type: Article in International Scientific Journal
• Date: 2020

Authors

Hui, SK (Author) Other; Sharma, A (Author) Other; Docherty, K (Author) Other; McMurray, JJV (Author) Other; Pitt, B (Author) Other; Dickstein, K (Author) Other; Pfeffer, MA (Author) Other; Girerd, N (Author) Other; Rossignol, P (Author) Other; Ferreira, JP (Author) FMUP; Zannad, F (Author) Other

Journal

Title: European Heart Journal: Acute Cardiovascular Care

ISSN: 2048-8726

Publisher: SAGE

Other information

Authenticus ID: P-00V-8QB

DOI: 10.1093/ehjacc/zuaa012

Abstract (EN): <jats:title>Abstract</jats:title> <jats:sec> <jats:title>Aims</jats:title> <jats:p>Among patients with acute myocardial infarction (AMI) complicated by heart failure [HF; clinical HF or left ventricular (LV) systolic dysfunction], we explored the probability of subsequent non-fatal cardiovascular (CV) events and sudden cardiac death (SCD).</jats:p> </jats:sec> <jats:sec> <jats:title>Methods and results</jats:title> <jats:p>The high-risk myocardial infarction (HRMI) database contains 28 771 patients with signs of HF or reduced LV ejection fraction (<40%) after AMI. We evaluated the temporal association between SCD with preceding non-fatal CV event [HF hospitalization, recurrent myocardial infarction (MI), or stroke]. Median follow-up was 1.9 years. Mean age was 65.0¿±¿11.5 years and 70% were male. The incidence of CV death was 7.9 per 100 patient-years and for SCD was 3.1 per patient-years (40% of CV deaths). The incidence of SCD preceded by HF hospitalization was greater than SCD without preceding HF hospitalization (P¿<¿0.05). However, overall, SCD was less likely to be preceded by a non-fatal CV event compared to other causes of death: 9.6% of SCD events were preceded by an MI (vs. 46.6% for non-sudden CV death); 17.0% of SCD events were preceded with an HF hospitalization (vs. 25.4% for non-sudden CV death); and 2.7% of SCD events were preceded by stroke (vs.12.9% for non-sudden CV death).</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion</jats:title> <jats:p>Among patients with AMI complicated by HF, SCD, compared with other causes of death, was less likely to be preceded by a non-fatal CV event. As patients are less likely to have preceding non-fatal CV events to alert the healthcare team of a possible impending SCD event, additional strategies for risk stratification for SCD are needed.</jats:p> </jats:sec>

Language: English

Type (Professor's evaluation): Dissemination