Predictors of Sudden Cardiac Death in High-Risk Patients Following a Myocardial Infarction
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Why the study?
The study was conducted to develop a risk model for sudden cardiac death in high-risk acute myocardial infarction survivors.
Population
13 202 high-risk AMI survivors from CAPRICORN and VALIANT with validation in EPHESUS
Design
Risk model derivation and validation study
Follow-up
Median 2.0 years
Authors
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Implication
May aid post-AMI SCD risk stratification; leaves open prospective validation before clinical use.
Structured PICO
P
Population
19,834 patients (13,202 in derivation cohort, 6,632 in validation cohort) with left ventricular systolic dysfunction, heart failure, or both, enrolled between 12 hours and 21 days following an acute myocardial infarction. Mean age 64.1 years, 29.8% female.
O
Outcome
Sudden cardiac death (SCD) with non-SCD as a competing risk over a median follow-up of 2.0 yearshard clinical
An 11-variable clinical risk score predicts sudden cardiac death in high-risk acute myocardial infarction survivors significantly better than left ventricular ejection fraction alone.
Limitations
- Post-hoc analysis of clinical trial patients (selected population)
- Differing definitions of SCD and maximum time from AMI to randomization across trials
- Unable to account for implantable cardioverter defibrillator use following randomization
- Missing variables such as potassium and treatment with RAAS inhibitors or beta-blockers
- Trials are over 15 years old and may not represent contemporary clinical practice
Cite This Study
Docherty et al. (2020) studied this question.
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