Key result
SCN5A mutations in Brugada syndrome linked to ~103% higher major arrhythmic event risk in Asians.
Why the study?
Does the presence of SCN5A mutations increase the risk of major arrhythmic events in patients with Brugada syndrome?
Meta-Analysis (n=1,049)
Does the presence of SCN5A mutations increase the risk of major arrhythmic events in patients with Brugada syndrome?
SCN5A mutation status is associated with a significantly increased risk of major arrhythmic events in Asian, symptomatic, and spontaneous type-1 Brugada syndrome patients, suggesting its utility for risk stratification.
Answers are grounded in this paper and cite their sources.
Supports SCN5A testing for Brugada risk stratification; extends prognostic evidence to Asian cohorts.
Background Brugada syndrome (BrS) is an inherited arrhythmic disease linked to SCN5A mutations. It is controversial whether SCN5A mutation carriers possess a greater risk of major arrhythmic events (MAE). We examined the association of SCN5A mutations and MAE in BrS patients. Methods We comprehensively searched the databases of MEDLINE and EMBASE from inception to September 2017. Included studies were published cohort and case–control studies that compared MAE in BrS patients with and without SCN5A mutations. Data from each study were combined using the random‐effects model. Generic inverse variance method of DerSimonian and Laird was employed to calculate the risk ratios (RR) and 95% confidence intervals (CI). Results Seven studies from March 2002 to October 2017 were included (1,049 BrS subjects). SCN5A mutations were associated with MAE in Asian populations (RR = 2.03, 95% CI: 1.37–3.00, p = 0.0004, I 2 = 0.0%), patients who were symptomatic (RR = 2.66, 95% CI: 1.62–4.36, p = 0.0001, I 2 = 23.0%), and individuals with spontaneous type‐1 Brugada pattern (RR = 1.84, 95% CI: 1.05–3.23, p = 0.03, I 2 = 0.0%). Conclusions SCN5A mutations in BrS increase the risk of MAE in Asian populations, symptomatic BrS patients, and individuals with spontaneous type‐1 Brugada pattern. Our study suggests that SCN5A mutation status should be an important tool for risk assessment in BrS patients.
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Rattanawong et al. (2018) conducted a meta-analysis in Brugada syndrome (n=1,049). SCN5A mutations vs. Without SCN5A mutations was evaluated on Major arrhythmic events (MAE) in Asian populations (RR 2.03, 95% CI 1.37-3.00, p=0.0004). SCN5A mutations in Brugada syndrome significantly increased the risk of major arrhythmic events in Asian populations (RR 2.03; 95% CI 1.37-3.00; p=0.0004).
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