Zelenkofske, S., McMurray, J.J.V. , Califf, R.M., Rouleau, J.L., Pfeffer, M.A., Ertl, G., Harsanyi, A. and Solomon, S.D. (2004) Do sudden cardiac death rates warrant earlier treatment following myocardial infarction? experience from the VALIANT Trial. Journal of Cardiac Failure, 10(4), S71. (doi: 10.1016/j.cardfail.2004.06.196)
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Abstract
Purpose: Patients with left ventricular ejection fraction (LVEF) ≤30% following myocardial infarction (MI) are at greater risk for sudden cardiac death (SCD). Current guidelines recommend implantable cardioverter defibrillator (ICD) placement in patients with EF ≤30% beyond 30 days post-MI. We determined the incidence and timing of SCD in a high-risk MI population. Methods: The VALsartan In Acute myocardial iNfarcTion (VALIANT) trial enrolled 14,703 patients with left ventricular systolic dysfunction (LVSD), heart failure (HF), or both following MI (median 4.9 days post-MI, mean age 64.8 years, 31% women, mean EF 35.3%). SCD was defined as unexpected out-of-hospital death by a central committee. Results: EF was recorded in 11,338 patients. A total of 925 patients experienced SCD during the study. Of these, 634 occurred in the first year and 131 occurred within 30 days. Among patients with EF ≤30% (n = 2468), 335 had SCD in year 1 with 74 occurring ≤30 days. Of 5830 patients with EF 30–40%, 213 had SCD in year 1 with 38 occurring ≤30 days. Of 3040 patients with EF >40%, only 84 had SCD in the first year (Figure). Conclusions: More than half of the patients who had SCD post-MI had an EF <30%. In patients meeting current LVEF criteria for ICD, 22% had sudden death within 30 days of MI, suggesting a role for earlier implantation of ICD after MI.[figure1]
Item Type: | Articles |
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Additional Information: | Abstracts from the 8th Annual Scientific Meeting of the Heart Failure Society of America. |
Status: | Published |
Refereed: | Yes |
Glasgow Author(s) Enlighten ID: | McMurray, Professor John |
Authors: | Zelenkofske, S., McMurray, J.J.V., Califf, R.M., Rouleau, J.L., Pfeffer, M.A., Ertl, G., Harsanyi, A., and Solomon, S.D. |
College/School: | College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health |
Journal Name: | Journal of Cardiac Failure |
Publisher: | Elsevier |
ISSN: | 1071-9164 |
ISSN (Online): | 1532-8414 |
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