Sudden cardiac death in patients with stable coronary artery disease and preserved left ventricular systolic function
| Autor: | Torbjørn Omland, Aldo P. Maggioni, Judith Hsia, Madeline Murguia Rice, Greg C. Flaker, Scott D. Solomon, Nancy L. Geller, Jean L. Rouleau, Michael J. Domanski, Marc S. Sabatine, Kathleen A. Jablonski, Miguel Zabalgoitia, Thomas E. Cuddy |
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| Rok vydání: | 2007 |
| Předmět: |
Trandolapril
Male medicine.medical_specialty Cardiotonic Agents Indoles Systole Myocardial Infarction Angiotensin-Converting Enzyme Inhibitors Coronary Artery Disease Placebo Sudden death Risk Assessment Ventricular Function Left Sudden cardiac death Angina Pectoris Coronary artery disease Sex Factors hemic and lymphatic diseases Internal medicine medicine Myocardial Revascularization Humans cardiovascular diseases Diuretics Proportional Hazards Models Ejection fraction business.industry Proportional hazards model Racial Groups Age Factors Digitalis Glycosides Stroke Volume Middle Aged medicine.disease Death Sudden Cardiac Circulatory system Multivariate Analysis Cardiology Female Cardiology and Cardiovascular Medicine business Algorithms medicine.drug |
| Zdroj: | The American journal of cardiology. 101(4) |
| ISSN: | 0002-9149 |
| Popis: | Although sudden cardiac death (SCD) has been extensively studied in patients with coronary artery disease (CAD) and low ejection fraction, prediction of SCD among individuals with preserved left ventricular systolic function is less well understood. We randomized 8,290 patients with stable CAD with preserved left ventricular systolic function to trandolapril or placebo in a secondary coronary prevention trial, and we used Cox proportional hazards models to identify independent baseline predictors of SCD during 4.8 year follow-up (median). Using a risk scoring algorithm based on simple clinical characteristics, we were able to distinguish individuals at higher risk for SCD. Independent determinants of SCD included age (p0.001), current angina pectoris (p = 0.002), ejection fraction40% to50% (as opposed to50%) (p0.001), and diuretic (p0.001) and digitalis use (p0.001). Negative predictors included having prior coronary revascularization (p = 0.01) and being female (p = 0.02) or Caucasian (p = 0.006). Trandolapril neither increased nor decreased SCD. Thus, among patients with stable CAD with preserved left ventricular systolic function receiving current standard-of-care including coronary revascularization, clinical characteristics can identify individuals at higher risk for SCD. |
| Databáze: | OpenAIRE |
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