Frequency of sudden cardiac death among acute myocardial infarction survivors with optimized medical and revascularization therapy

Timo H. Mäkikallio, Petra Barthel, Raphael Schneider, Axel Bauer, Jari M. Tapanainen, Mikko P. Tulppo, Juha S. Perkiömäki, Georg Schmidt, Heikki V. Huikuri

Research output: Contribution to journalArticlepeer-review

59 Scopus citations

Abstract

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 <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 <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. Coronary revascularization seems to have a great effect on altered the epidemiologic pattern of SCD.

Original languageEnglish
Pages (from-to)480-484
Number of pages5
JournalAmerican Journal of Cardiology
Volume97
Issue number4
DOIs
StatePublished - 15 Feb 2006

Fingerprint

Dive into the research topics of 'Frequency of sudden cardiac death among acute myocardial infarction survivors with optimized medical and revascularization therapy'. Together they form a unique fingerprint.

Cite this