Frequency of Sudden Cardiac Death Among Acute Myocardial Infarction Survivors With Optimized Medical and Revascularization Therapy

The epidemiologic pattern of sudden cardiac death (SCD) may have changed in the modern treatment era of patients after an acute myocardial infarction (AMI). We evaluated the effect of optimized medical and revascularization therapy on the incidence of SCD after an AMI. A total of 2,130 consecutive p...

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Published in:The American journal of cardiology 2006-02, Vol.97 (4), p.480-484
Main Authors: Mäkikallio, Timo H., Barthel, Petra, Schneider, Raphael, Bauer, Axel, Tapanainen, Jari M., Tulppo, Mikko P., Perkiömäki, Juha S., Schmidt, Georg, Huikuri, Heikki V.
Format: Article
Language:English
Subjects:
Adrenergic beta-Antagonists - therapeutic use
Angiotensin-Converting Enzyme Inhibitors - therapeutic use
Aspirin - therapeutic use
Biological and medical sciences
Cardiology. Vascular system
Coronary heart disease
Death, Sudden, Cardiac - etiology
Epidemiology
Fatalities
Female
Follow-Up Studies
Heart
Heart attacks
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use
Male
Medical sciences
Medical treatment
Middle Aged
Myocardial Infarction - mortality
Myocardial Infarction - therapy
Myocardial Revascularization
Myocarditis. Cardiomyopathies
Therapy
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creator Mäkikallio, Timo H.
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Schmidt, Georg
Huikuri, Heikki V.
description The epidemiologic pattern of sudden cardiac death (SCD) may have changed in the modern treatment era of patients after an acute myocardial infarction (AMI). We evaluated the effect of optimized medical and revascularization therapy on the incidence of SCD after an AMI. A total of 2,130 consecutive patients (mean age 59 ± 10 years) with an AMI from 2 European centers (Germany and Finland) was included in the study. In this population, 1,004 patients (47%) were treated with an optimized medical and revascularization strategy (defined as treatment with revascularization, β blockers, aspirin, statins, and angiotensin-converting enzyme inhibitors). Nonoptimized treatment, defined as a lack of any optimized treatment, was received by 1,126 patients (53%). During the mean follow-up of 2.9 ± 1.3 years, the incidence of SCD was very low among patients who received optimized treatment (1.2%, annual incidence 0.4%) compared with those who did not (3.6%, annual incidence 1.4%, p
doi_str_mv 10.1016/j.amjcard.2005.09.077
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We evaluated the effect of optimized medical and revascularization therapy on the incidence of SCD after an AMI. A total of 2,130 consecutive patients (mean age 59 ± 10 years) with an AMI from 2 European centers (Germany and Finland) was included in the study. In this population, 1,004 patients (47%) were treated with an optimized medical and revascularization strategy (defined as treatment with revascularization, β blockers, aspirin, statins, and angiotensin-converting enzyme inhibitors). Nonoptimized treatment, defined as a lack of any optimized treatment, was received by 1,126 patients (53%). During the mean follow-up of 2.9 ± 1.3 years, the incidence of SCD was very low among patients who received optimized treatment (1.2%, annual incidence 0.4%) compared with those who did not (3.6%, annual incidence 1.4%, p &lt;0.01). The treatment strategy that had the greatest effect on differences in the SCD rate was revascularization therapy, with the hazard ratio of SCD being 2.1 (95% confidence interval 1.2 to 3.7, p &lt;0.01) for SCD among nonrevascularized patients. Nonoptimized treatment was more often received by older patients, women, diabetic patients, and those with depressed left ventricular function. In conclusion, the incidence of SCD is low in the modern treatment era of patients after an AMI. 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subjects Adrenergic beta-Antagonists - therapeutic use
Angiotensin-Converting Enzyme Inhibitors - therapeutic use
Aspirin - therapeutic use
Biological and medical sciences
Cardiology. Vascular system
Coronary heart disease
Death, Sudden, Cardiac - etiology
Epidemiology
Fatalities
Female
Follow-Up Studies
Heart
Heart attacks
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use
Male
Medical sciences
Medical treatment
Middle Aged
Myocardial Infarction - mortality
Myocardial Infarction - therapy
Myocardial Revascularization
Myocarditis. Cardiomyopathies
Therapy
title Frequency of Sudden Cardiac Death Among Acute Myocardial Infarction Survivors With Optimized Medical and Revascularization Therapy
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