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Determinants of sudden death after discharge from hospital for myocardial infarction in the thrombolytic era
- Source :
- European Heart Journal, 22, 1214-1225. Oxford University Press
- Publication Year :
- 2001
-
Abstract
- Aims The purpose of this study was to assess risk factors for sudden death after discharge from hospital for myocardial infarction in an era in which 50% of patients receive thrombolytic drugs. Methods and Results We prospectively studied 708 consecutive survivors of myocardial infarction admitted to hospitals, which had registered their clinical, functional, and electrical parameters. A total of 83 patients died in the first 2 years (12%) after discharge. Sudden death was only observed in 12 patients. In multivariate analysis only NYHA class >I, and a filtered QRS duration ≥110ms were important predictive variables for sudden death. A pre-defined high-risk group of 25 patients had no sudden death. When the strongest predictive variables in univariate analysis were combined to increase the positive predictive value for sudden death, we only achieved a maximal value of 27%. Conclusions In an unselected infarction population, the risk for sudden death is low in the first 2 years. Therefore, prediction and prophylactic intervention, such as defibrillator therapy become difficult. The event is related to cardiac dysfunction on admission, and with abnormalities in the filtered electrocardiogram.
- Subjects :
- Adult
Male
medicine.medical_specialty
Population
Myocardial Infarction
Infarction
Sudden death
Coronary artery disease
QRS complex
Electrocardiography
Belgium
Predictive Value of Tests
Risk Factors
Internal medicine
medicine
Odds Ratio
Prevalence
Humans
Thrombolytic Therapy
Myocardial infarction
Prospective Studies
Registries
education
Aged
Aged, 80 and over
Univariate analysis
education.field_of_study
business.industry
Middle Aged
medicine.disease
Survival Analysis
Signal-averaged electrocardiogram
Patient Discharge
Death, Sudden, Cardiac
Multivariate Analysis
Cardiology
Female
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 0195668X
- Volume :
- 22
- Issue :
- 14
- Database :
- OpenAIRE
- Journal :
- European heart journal
- Accession number :
- edsair.doi.dedup.....bc4ebdd714fb287991dfe9ba25e7d387