Key result
No single predictor has sufficient predictive value to guide preventative therapy for sudden cardiac death, prompting efforts to combine markers to define high-risk cohorts.
No single predictor has sufficient predictive value for sudden cardiac death risk stratification, highlighting the need for combined marker risk profiles.
Clinicians should avoid single-marker SCD risk stratification for therapy decisions; leaves open whether validated multi-marker profiles can guide prevention.
Sudden cardiac death (SCD) is the leading cause of cardiovascular mortality and a major international health problem, with an estimated 3.7 million deaths occurring annually, accounting for approximately 15%–20% of all deaths worldwide. The implantable cardiac defibrillator (ICD) is an effective treatment of SCD and has had a major impact on outcomes. However, this therapy has been largely used in patients with left ventricular dysfunction. A changing epidemiology of SCD with fewer patients having marked reductions in left ventricular ejection fraction (LVEF) has renewed the focus on identifying other high risk populations. This article summarizes the current understanding of the diverse clinical, genetic, racial, electrocardiographic and imaging techniques available to detect patients most at risk. Despite many identified risk factors, no single predictor has been shown to have sufficient predictive value to be used to guide preventative therapy and reduce mortality. More recent effort has been directed towards combining markers to define a risk profile for identifying high risk cohorts.
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Gold et al. (2016) conducted a review in Sudden cardiac death. No single predictor has sufficient predictive value to guide preventative therapy for sudden cardiac death, prompting efforts to combine markers to define high-risk cohorts.
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