Key result
Silent myocardial infarction is linked to a ~10-fold higher risk of sudden cardiac death in women.
Why the study?
CAD is the most common cause of SCD in both sexes and often the first manifestation in women, but factors associated with CAD-related SCD in women needed determination.
Case-Control (n=1,498)
Underlying left ventricular hypertrophy and previous silent myocardial infarction are highly prevalent and often undiagnosed in women experiencing CAD-related sudden cardiac death, highlighting a critical need for improved detection and sex-specific risk stratification.
Answers are grounded in this paper and cite their sources.
Silent MI and LVH may mark elevated SCD risk in women with CAD; hypothesis-generating pending prospective validation.
BACKGROUND: Sudden cardiac death (SCD) is a significant mode of death causing 15-20% of all deaths in high-income countries. Coronary artery disease (CAD) is the most common cause of SCD in both sexes, and SCD is often the first manifestation of underlying CAD in women. This case-control study aimed to determine the factors associated with SCD due to CAD in women. METHODS: = 610). To compare these groups, we used medical records, autopsy findings, echocardiograms, and electrocardiograms (ECGs). Various electrocardiographic abnormalities were more common in subjects with SCD, including higher heart rate, atrial fibrillation, prolonged QTc interval, wide or fragmented QRS complex and early repolarization. The prevalence of Q waves and T inversions did not differ between the groups. CONCLUSIONS: Underlying LVH and previous MI with myocardial scarring are common and often undiagnosed in women with CAD-related SCD. These results suggest that untreated CAD with concomitant myocardial disease is an important factor in SCD in women.
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Hookana et al. (2023) conducted a case-control in Coronary artery disease and sudden cardiac death (n=1,498). Coronary artery disease-related sudden cardiac death vs. Angiographically diagnosed CAD without sudden cardiac death was evaluated on Prevalence of silent myocardial infarction (p=<0.001). Women with CAD-related sudden cardiac death had a significantly higher prevalence of silent myocardial infarctions (25.6% vs 2.4%) and left ventricular hypertrophy (70.9% vs 55.1%) compared to living women with CAD.
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