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. Issue 2 (28th August 2020)

• Record Type: Journal Article
• Authors: Hui, Sonya K; Sharma, Abhinav; Docherty, Kieran; McMurray, John J V; Pitt, Bertram; Dickstein, Kenneth; Pfeffer, Marc A; Girerd, Nicolas; Rossignol, Patrick; Ferreira, João Pedro; Zannad, Faiez
• Is Part Of: European heart journal. Volume 10:Issue 2(2021)
• Page Start: 127
• Page End: 131
• Publication Date: 2020-08-28
• Subjects: Sudden cardiac death -- Acute myocardial infarction -- Heart failure -- Left ventricular dysfunction; 616.1205
• DOI: 10.1093/ehjacc/zuaa012
• Languages: English
• ISSNs: 2048-8726

Abstract

Abstract: Aims: 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). Methods and results: 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). Conclusion: 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.