Predictors of sudden cardiac death in long-term follow-up in patients with ST-elevation myocardial infarction treated with primary percutaneous coronary intervention. (3rd May 2023)

• Record Type: Journal Article
• Authors: Savic, L; Mrdovic, I G O R; Asanin, M I L I K A; Lasica, R A T K O; Krljanac, G; Rajic, D; Simic, D A M J A N; Kastel, B
• Is Part Of: European heart journal. Volume 12(2023)Supplement 1
• Publication Date: 2023-05-03
• Subjects: 616.1205
• DOI: 10.1093/ehjacc/zuad036.041
• Languages: English
• ISSNs: 2048-8726

Abstract

Abstract: Funding Acknowledgements: Type of funding sources: None. Background: Despite timely and successful reperfusion tretment with primary percutaneous coronary intervention (pPCI), some patients have a high risk of mortality and SCD. Aim: The aim of our study was to analyze the incidence of SCD and determine the predictors of SCD occurrence during 6-year follow-up of patients with ST-elevation myocardial infarction (STEMI), treated with primary PCI. Method: we analysed 3114 consecutive STEMI patients. Patients presenting with cardiogenic schock were excluded. Echocardiographic examination was performed before hospital discharge and left ventricular ejection fraction (EF) was calculated using bi-plane method. The follow-up period was 6 years. Results: During 6-year follow-up, lethal outcome was registered in a total of 297 (9.5%) patients, of whom 95 (31.9%) had SCD. The highest incidence of SCD was recorded in the first year of follow-up, when SCD was registered in 25 patients, which is 26.3% of the total number of patients who had had SCD, i.e., 0.8% of the patients analyzed (Figure 1). The independent predictors for the occurrence of SCD during 6-year follow-up were EF<45% (HR 3.07, 95% 1.87-5.02), post-procedural TIMI flow <3 (HR 2.59, 95%CI 1.37-5.14), reduced baseline kidney function (HR 1.87, 95%CI 1.12-2.93) and Killip class >1 at admission (HR 1.69, 95%CI 1.23-2.97). Conclusion: There is a low incidence of SCD in unselected STEMI patients treated with primary PCI. The independent predictors of SCD during long-term follow-up, in the patients analyzed, are: EF ≤ 45%, post-procedural flow TIMI < 3, Killip class > 1, and reduced baseline kidney function.