In-hospital predictors for primary prevention of sudden death after acute myocardial infarction with cardiac dysfunction
Copyright © 2023 Elsevier Ltd. All rights reserved..
BACKGROUND: Current guidelines recommend prophylactic defibrillator implantation in patients with acute myocardial infarction (AMI) and left ventricular ejection fraction (LVEF) ≤40 % or LVEF ≤35 % plus heart failure symptoms or inducible ventricular tachyarrhythmias during an electrophysiology study at 40 days after AMI or 90 days after revascularization. In-hospital predictors of sudden cardiac death (SCD) after AMI during the index hospitalization remain unsettled. We sought to examine in-hospital predictors of SCD in patients with AMI and LVEF ≤40 % evaluated during the index hospitalization.
METHODS: We retrospectively evaluated 441 consecutive patients with AMI and LVEF ≤40 % admitted to our hospital between 2001 and 2014 (77 % male gender; median age: 70 years; median hospitalization length: 23 days). The primary endpoint was a composite of SCD or aborted SCD at ≥30 days after AMI onset (composite arrhythmic event). LVEF and QRS duration (QRSd) on electrocardiography were measured at a median of 12 days and 18 days, respectively.
RESULTS: During a median follow-up of 7.6 years, the incidence of composite arrhythmic events was 7.3 % (32 of 441 patients). In multivariable analysis, QRSd ≥100 msec (beta-coefficient = 1.54, p = 0.003), LVEF ≤23 % (beta-coefficient = 1.14, p = 0.007), and onset-reperfusion time > 5.5 h (beta-coefficient = 1.16, p = 0.035) were independent predictors of composite arrhythmic events. The combination of these 3 factors was associated with the highest rate of composite arrhythmic events compared with 0-2 factors (p < 0.001).
CONCLUSIONS: The combination of QRSd ≥100 msec, LVEF ≤23 %, and onset-reperfusion time > 5.5 h during the index hospitalization provides precise risk stratification for SCD in patients early after AMI.
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:82 |
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| Enthalten in: |
Journal of cardiology - 82(2023), 3 vom: 15. Sept., Seite 186-193 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Konagai, Nao [VerfasserIn] |
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| Links: |
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| Themen: |
Acute myocardial infarction |
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| Anmerkungen: |
Date Completed 28.07.2023 Date Revised 25.10.2023 published: Print-Electronic CommentIn: J Cardiol. 2023 Dec;82(6):504. - PMID 37640153 Citation Status MEDLINE |
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| doi: |
10.1016/j.jjcc.2023.05.003 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM356899470 |
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| 245 | 1 | 0 | |a In-hospital predictors for primary prevention of sudden death after acute myocardial infarction with cardiac dysfunction |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
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| 500 | |a Date Completed 28.07.2023 | ||
| 500 | |a Date Revised 25.10.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentIn: J Cardiol. 2023 Dec;82(6):504. - PMID 37640153 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 Elsevier Ltd. All rights reserved. | ||
| 520 | |a BACKGROUND: Current guidelines recommend prophylactic defibrillator implantation in patients with acute myocardial infarction (AMI) and left ventricular ejection fraction (LVEF) ≤40 % or LVEF ≤35 % plus heart failure symptoms or inducible ventricular tachyarrhythmias during an electrophysiology study at 40 days after AMI or 90 days after revascularization. In-hospital predictors of sudden cardiac death (SCD) after AMI during the index hospitalization remain unsettled. We sought to examine in-hospital predictors of SCD in patients with AMI and LVEF ≤40 % evaluated during the index hospitalization | ||
| 520 | |a METHODS: We retrospectively evaluated 441 consecutive patients with AMI and LVEF ≤40 % admitted to our hospital between 2001 and 2014 (77 % male gender; median age: 70 years; median hospitalization length: 23 days). The primary endpoint was a composite of SCD or aborted SCD at ≥30 days after AMI onset (composite arrhythmic event). LVEF and QRS duration (QRSd) on electrocardiography were measured at a median of 12 days and 18 days, respectively | ||
| 520 | |a RESULTS: During a median follow-up of 7.6 years, the incidence of composite arrhythmic events was 7.3 % (32 of 441 patients). In multivariable analysis, QRSd ≥100 msec (beta-coefficient = 1.54, p = 0.003), LVEF ≤23 % (beta-coefficient = 1.14, p = 0.007), and onset-reperfusion time > 5.5 h (beta-coefficient = 1.16, p = 0.035) were independent predictors of composite arrhythmic events. The combination of these 3 factors was associated with the highest rate of composite arrhythmic events compared with 0-2 factors (p < 0.001) | ||
| 520 | |a CONCLUSIONS: The combination of QRSd ≥100 msec, LVEF ≤23 %, and onset-reperfusion time > 5.5 h during the index hospitalization provides precise risk stratification for SCD in patients early after AMI | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Acute myocardial infarction | |
| 650 | 4 | |a Coronary reperfusion | |
| 650 | 4 | |a Electrocardiography | |
| 650 | 4 | |a Left ventricular dysfunction | |
| 650 | 4 | |a Sudden cardiac death | |
| 700 | 1 | |a Asaumi, Yasuhide |e verfasserin |4 aut | |
| 700 | 1 | |a Murata, Shunsuke |e verfasserin |4 aut | |
| 700 | 1 | |a Noda, Takashi |e verfasserin |4 aut | |
| 700 | 1 | |a Takeuchi, Satoshi |e verfasserin |4 aut | |
| 700 | 1 | |a Fujino, Masashi |e verfasserin |4 aut | |
| 700 | 1 | |a Honda, Satoshi |e verfasserin |4 aut | |
| 700 | 1 | |a Yoneda, Shuichi |e verfasserin |4 aut | |
| 700 | 1 | |a Kataoka, Yu |e verfasserin |4 aut | |
| 700 | 1 | |a Otsuka, Fumiyuki |e verfasserin |4 aut | |
| 700 | 1 | |a Nishimura, Kunihiro |e verfasserin |4 aut | |
| 700 | 1 | |a Tsujita, Kenichi |e verfasserin |4 aut | |
| 700 | 1 | |a Kusano, Kengo |e verfasserin |4 aut | |
| 700 | 1 | |a Noguchi, Teruo |e verfasserin |4 aut | |
| 700 | 1 | |a Yasuda, Satoshi |e verfasserin |4 aut | |
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