Sudden death and its predictors in myocardial infarction survivors in an Indian population
| Autor: | Sasinthar Rangasamy, Ajith Ananthakrishna Pillai, Santhosh Satheesh, Balachander Jayaraman, Dhivya Priya, Sreekumaran Nair, Raja J. Selvaraj |
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| Rok vydání: | 2020 |
| Předmět: |
T wave alternans
medicine.medical_specialty lcsh:Diseases of the circulatory (Cardiovascular) system Risk predictors Ventricular tachycardia Sudden death Heart rate turbulence Sudden cardiac death Physiology (medical) Internal medicine Medicine Heart rate variability Myocardial infarction cardiovascular diseases Ejection fraction business.industry medicine.disease lcsh:RC666-701 Cardiology cardiovascular system Original Article Cardiology and Cardiovascular Medicine business |
| Zdroj: | Indian Pacing and Electrophysiology Journal Indian Pacing and Electrophysiology Journal, Vol 21, Iss 2, Pp 82-87 (2021) |
| ISSN: | 0972-6292 |
| Popis: | Objective This study was conducted to assess the incidence of sudden cardiac death (SCD) in post myocardial infarction patients and to determine the predictive value of various risk markers in identifying cardiac mortality and SCD. Methods Left ventricular function, arrhythmias on Holter and microvolt T wave alternans (MTWA) were assessed in patients with prior myocardial infarction and ejection fraction ≤ 40%. The primary outcome was a composite of cardiac death and resuscitated cardiac arrest during follow up. Secondary outcomes included total mortality and SCD. Results Fifty-eight patients were included in the study. Eight patients (15.5%) died during a mean follow-up of 22.3 ± 6.6 months. Seven of them (12.1%) had SCD. Among the various risk markers studied, left ventricular ejection fraction (LVEF) ≤ 30% (Hazard ratio 5.6, 95% CI 1.39 to 23) and non-sustained ventricular tachycardia (NSVT) in holter (5.7, 95% CI 1.14 to 29) were significantly associated with the primary outcome in multivariate analysis. Other measures, including QRS width, heart rate variability, heart rate turbulence and MTWA showed no association. Conclusions Among patients with prior myocardial infarction and reduced left ventricular function, the rate of cardiac death was substantial, with most of these being sudden cardiac death. Both LVEF ≤30% and NSVT were associated with cardiac death whereas only LVEF predicted SCD. Other parameters did not appear useful for prediction of events in these patients. These findings have implications for decision making for the use of implantable cardioverter defibrillators for primary prevention in these patients. |
| Databáze: | OpenAIRE |
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