SCD Accounts for >30 Percent of CV Deaths After NSTE ACS
Patients with recurrent myocardial infarction or rehospitalization have increased risk of SCD
THURSDAY, March 17, 2016 (HealthDay News) -- Sudden cardiac death (SCD) accounts for more than 30 percent of cardiovascular deaths after non-ST segment elevation acute coronary syndrome (NSTE ACS), according to research published online March 16 in JAMA Cardiology.
Paul L. Hess, M.D., from the Veterans Affairs Eastern Colorado and Health Care System in Denver, and colleagues determined the cumulative incidence of SCD during long-term follow-up after NSTE ACS in an analysis that merged individual data from four trials; 37,555 patients were enrolled after NSTE ACS. Baseline factors were used to develop a risk model for SCD.
The researchers found that after a median follow-up of 12.1 months there were 2,109 deaths among these patients. Overall, 31.3 percent of the 1,640 cardiovascular deaths were SCD. The cumulative incidence estimates of SCD were 0.79, 1.65, and 2.37 percent, respectively, at six, 12, and 30 months. Multiple factors were identified that were significantly associated with SCD. The C-index was 0.77 for a model developed to calculate the risk of SCD in trials with systemic collection of left ventricular ejection fraction. Based on this model, an integer-based score was developed which yielded a calculated SCD probability varying from 0.1 to 56.7 percent (C-statistic, 0.75). SCD correlated with recurrent myocardial infarction and any hospitalization (hazard ratios, 2.95 and 2.45, respectively), in a multivariable model.
"In the current therapeutic era, SCD accounts for about one-third of cardiovascular deaths after NSTE ACS," the authors write.
Several authors disclosed financial ties to the pharmaceutical industry, including several companies which funded the four trials.