BACKGROUND: Sudden death is common in chronic heart failure (CHF). Risk stratification is the first step for primary prevention. AIM: To evaluate the use of risk markers for estimating sudden death risk. METHODS AND RESULTS: We prospectively examined 680 stable patients with CHF. Risk markers were evaluated using the Cox's proportional hazard model in a stepwise manner. Ejection fraction <30%, left ventricular end-diastolic diameter >60 mm, brain natriuretic peptide >200 pg/ml, non-sustained ventricular tachycardia, and diabetes were significantly associated with increased risk of sudden death. When the number of risk markers were included as co-variables, only "number of risk markers >or=3'' entered the model (hazard ratio 8.95, 95% confidence interval 4.57-17.52), while the effects of individual markers did not enter the model. The annual mortality from sudden death was 11% in patients with 3 or more risk markers and 1.4% in patients with 2 or less. CONCLUSIONS: Rather than particular risk markers, the number of accumulated risk markers was a more powerful predictor for sudden death in patients with CHF. The number of risk markers could be useful for risk stratification of sudden death.
BACKGROUND:Sudden death is common in chronic heart failure (CHF). Risk stratification is the first step for primary prevention. AIM: To evaluate the use of risk markers for estimating sudden death risk. METHODS AND RESULTS: We prospectively examined 680 stable patients with CHF. Risk markers were evaluated using the Cox's proportional hazard model in a stepwise manner. Ejection fraction <30%, left ventricular end-diastolic diameter >60 mm, brain natriuretic peptide >200 pg/ml, non-sustained ventricular tachycardia, and diabetes were significantly associated with increased risk of sudden death. When the number of risk markers were included as co-variables, only "number of risk markers >or=3'' entered the model (hazard ratio 8.95, 95% confidence interval 4.57-17.52), while the effects of individual markers did not enter the model. The annual mortality from sudden death was 11% in patients with 3 or more risk markers and 1.4% in patients with 2 or less. CONCLUSIONS: Rather than particular risk markers, the number of accumulated risk markers was a more powerful predictor for sudden death in patients with CHF. The number of risk markers could be useful for risk stratification of sudden death.
Authors: Marwan M Refaat; Bradley E Aouizerat; Clive R Pullinger; Mary Malloy; John Kane; Zian H Tseng Journal: Heart Rhythm Date: 2014-01-17 Impact factor: 6.343
Authors: Anita Spezzacatene; Gianfranco Sinagra; Marco Merlo; Giulia Barbati; Sharon L Graw; Francesca Brun; Dobromir Slavov; Andrea Di Lenarda; Ernesto E Salcedo; Jeffrey A Towbin; Jeffrey E Saffitz; Frank I Marcus; Wojciech Zareba; Matthew R G Taylor; Luisa Mestroni Journal: J Am Heart Assoc Date: 2015-10-16 Impact factor: 5.501