Reduced post-ectopic turbulence slope on Holter monitoring strongly predicted sudden cardiac death among post-AMI patients with preserved left ventricular function (HR 5.9; 95% CI 2.9-11.7, P<0.001).
Cohort (n=2,130)
Does Holter monitoring predict sudden cardiac death in survivors of acute myocardial infarction treated with modern therapy?
Holter monitoring variables, particularly turbulence slope, remain significant predictors of sudden cardiac death in post-AMI patients with preserved ejection fraction receiving modern therapy.
Hazard Ratio: 5.9 (95% CI 2.9–11.7)
p-value: p=<0.001
AIMS: Current treatment may have changed the risk profiles of survivors of acute myocardial infarction (AMI). We evaluated the utility of Holter-based risk variables in the prediction of sudden cardiac death (SCD) among survivors of AMI treated with modern therapy. METHODS AND RESULTS: A total of 2130 AMI patients (mean age 59 +/- 10 years) were included. The patients were treated with modern therapeutic strategies, for example, 94% were on beta-blocking therapy and 70% underwent coronary revascularization. Various risk parameters from Holter monitoring were analysed. During a median follow-up of 1012 days (interquartile range: 750-1416 days), cardiac mortality was 113/2130, including 52 SCDs. All Holter variables predicted the occurrence of SCD (P0.35, particularly TS (hazard ratio 5.9; 95% CI 2.9-11.7, P<0.001). CONCLUSION: Among the post-AMI patients treated according to the current guidelines, the incidence of SCD is low. Various Holter variables still predict the occurrence of SCD, particularly among the patients with preserved left ventricular function.
Mäkikallio et al. (Fri,) conducted a cohort in Acute myocardial infarction (n=2,130). Holter-based risk variables (reduced post-ectopic turbulence slope and non-sustained ventricular tachycardia) vs. Absence of Holter-based risk variables was evaluated on Sudden cardiac death (SCD) (HR 5.9, 95% CI 2.9-11.7, p=<0.001). Reduced post-ectopic turbulence slope on Holter monitoring strongly predicted sudden cardiac death among post-AMI patients with preserved left ventricular function (HR 5.9; 95% CI 2.9-11.7, P<0.001).
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