Factors related to sudden death in patients with acute myocardial infarction

Abstract

Introduction: Ischemic heart disease is an important cause of death in Cuba and the world.

Objective: To identify factors that influence sudden cardiac death (SCD) in patients with acute myocardial infarction (AMI).

Method: A retrospective study was performed at the “Hospital Hermanos Ameijeiras” Cardiocentro, from January/2007 to January/2016. The sample consisted of 455 patients with a diagnosis of AMI, divided into two groups, 79 deceased and 386 alive. Summary measures were used for quantitative and qualitative variables. Chi-square test was used to compare proportions.

Results: All of these factors were related to SCD in patients with AMI: hypertension (0.047), smoking (p<0.001), peripheral artery disease (p=0.002), dyslipidemia, arrhythmias (p<0.001), left ventricular ejection fraction <50% (p<0.001), increased end-diastolic diameter (53.0/11.0, p<0.001), non-ST elevation AMI (p=0.013), right coronary artery (p=0.011) and left main coronary artery (p=0.030) disease; as well as higher creatinine levels (p=0.006).

Conclusions: The clinical variables associated with the occurrence of SCD were: hypertension, smoking, peripheral artery disease, familial pathological history, and dyslipidemia. Arrhythmias, low ejection fraction, and increased left ventricular end-diastolic diameter were associated with SCD in AMI, where non-ST elevation AMI was more frequent. The right coronary artery and left main coronary artery disease, as well as high creatinine levels, were associated with SCD in these patients.