Risk factors for sudden death in patients with acute myocardial infarction

Authors

Abstract

Introduction: Several investigations have addressed the identification of clinical markers for the risk of sudden cardiac death in acute myocardial infarction.

Objectives: To determine the risk factors for this type of death in patients with acute myocardial infarction.

Methods: A case-control analytical study was conducted at the Department of Cardiology in Las Tunas from 2011 to 2017. The study population consisted of 1150 patients admitted for myocardial infarction previously registered in the department's database. The 45 patients who died from sudden death made up the “case group” and for each of them, 2 patients —who did not die suddenly— were randomly assigned to the “control group”. Descriptive statistics were used for descriptive variables. To assess risk factors, multivariate analyses were performed and the odds ratio (OR) was evaluated with 99% reliability.

Results: Male sex predominated in both groups and high blood pressure was the most frequent associated factor. Mean age and Killip-Kimball class III-IV percentage were similar. A 43% of patients with sudden death were diabetic and presented a higher percentage of biventricular infarctions (22.7%), ineffective thrombolysis (41.8%), and cardiac rupture (13.6%). Glycemia >15.0 mmol/L on admission (OR 2.57; p=0.027) and ineffective thrombolysis (OR 2.19; p=0.024) were associated with the occurrence of sudden death.

Conclusions: Both, Glycemia >15.0 mmol/L on admission and ineffective thrombolysis, behaved as risk factors for sudden death.

Downloads

Download data is not yet available.

References

1. Ferreira-González I. Epidemiologia de la enfermedad coronaria. Rev Esp Cardiol. 2014;67(2):139-44.

2. Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E. Braunwald Tratado de Cardiología: Texto de medicina cardiovascular. 10ª Ed. Barcelona: Elsevier, 2016.

3. Mele EF. Avances en la reperfusión del infarto agudo de miocardio. Realidad en Latinoamérica. Rev Esp Cardiol. 2010;63(Supl 2):12-9.

4. Marín F, Díaz-Castro O, Ruiz Nodar JM, García de la Villa B, Sionis A, López J, et al. Actualización en cardiopatía isquémica y cuidados críticos cardiológicos. Rev Esp Cardiol. 2014;67(2):120-6.

5. Josephson ME. Sudden cardiac arrest. Indian Heart J. 2014;66(Supl 1):2-3.

6. Abhilash SP, Namboodiri N. Sudden cardiac death historical perspectives. Indian Heart J. 2014;66(Supl 1):S4-9.

7. Israel CW. Mechanisms of sudden cardiac death. Indian Heart J. 2014;66(Supl 1):S10-7.

8. Vedanthan R, Fuster V, Fisher A. Sudden cardiac death in low and middle income countries. Glob Heart. 2012;7(4):353-60.

9. Buxton AE, Lee KL, Hafley GE, Pires LA, Fisher JD, Gold MR, et al. Limitations of ejection fraction for prediction of sudden death risk in patients with coronary artery disease: lessons from the MUSTT study. J Am Coll Cardiol. 2007;50(12):1150-7.

10. Chitnis N, Vooturi S, Rao BH. Sudden cardiac death early after ST elevation myocardial infarction with and without severe left ventricular dysfunction. Indian Heart J. 2014;66(6):569-73.

11. O’Rourke RA, Fuster V. Muerte súbita cardiaca. En: O’Rourke RA, Fuster V, Alexander RW. Hurst. El Corazón. Manual de Cardiologia. 11ª Ed. Madrid: McGraw-Hill Interamericana; 2006: 154-7.

12. Velazquez EJ, Pfeffer MA, McMurray JV, Maggioni AP, Rouleau JL, Van de Werf F, et al. Valsartan in acute myocardial infarction (VALIANT) trial: baseline characteristics in context. Europ J Heart Fail. 2003;349(20):1893-906.

13. Atwater BD, Thompson VP, Vest RN, Shaw LK, Mazzei WR, Al-Khatib SM, et al. Usefulness of the Duke sudden cardiac death risk score for predicting sudden cardiac death in patient with angiographic (>75% narrowing) coronary artery disease. Am J Cardiol. 2009;104(12):1624-30

14. Ministerio de Salud Pública. Anuario Estadístico de Salud 2017. La Habana: Dirección de Registros Médicos y Estadísticas de Salud; 2018.

15. Ragupathi L, Pavri BB. Tools for risk stratification of sudden cardiac death: A review of the literature in different patient populatios. Indian Heart J. 2014;66(Supl 1):S71-81.

16. Garg A. Primary prevention of sudden cardiac death-Challenge the guidelines. Indian Heart J. 2015;67(3):203-6.

17. Hess PL, Tricoci P, Horton J, Lokhnygina Y, Al-Khatib SM, Piccini J, et al. Incidence and predictors of sudden cardiac death after hospitalization for non-ST-segment elevation myocardial infarction: An analysis from the TRACER Trial. J Am Coll Cardiol. 2013,61(10_Supl):E109.

18. Dorantes Sánchez M. Despolarización y repolarización ventriculares para estratificar riesgo de arritmias ventriculares malignas y muerte súbita. CorSalud [Internet]. 2018 [citado 29 Ene 2020];10(3):266-9. Disponible en: http://www.revcorsalud.sld.cu/index.php/cors/article/view/351/719

19. Chávez González E. Despolarización (complejo QRS) o repolarización ventricular (intervalo QT): ¿quién aporta más al diagnóstico y pronóstico en distintos escenarios clínicos? CorSalud [Internet]. 2018 [citado 29 Ene 2020];10(1):1-3. Disponible en: http://www.revcorsalud.sld.cu/index.php/cors/article/view/289/623

20. Yodogawa K, Shimizu W. Noninvasive risk stratification of lethal ventricular arrhythmias and sudden cardiac death after myocardial infarction. J Arrhyth. 2014;30(4):230-4.

21. Ruesga Zamora EA, Saturno Chiu G. Cardiología 2ª Ed. México: Manual Moderno; 2011.

22. Keeley EC, Boura JA, Grines CL. Primary angioplasty versus intravenous thrombolytic therapy for acute myocardial infarction: a quantitative review of 23 randomized trials. Lancet. 2003;361(9351):13-20.

23. Timmer JR, Hoekstra M, Nijsten NM, van der Horst CIC, Ottervanger JP, Slingerland RJ, et al. Prognostic value of admission glycosylated hemoglobin and glucose in nondiabetic patients with ST-segment-elevation myocardial infarction treated with percutaneous coronary intervention. Circulation. 2011;124(6):704-11.

Downloads

Published

2020-10-31

How to Cite

1.
Santos Medina M, Ricardo Mora E, Rodríguez Ramos MA, Batista Bofill S. Risk factors for sudden death in patients with acute myocardial infarction. CorSalud [Internet]. 2020 Oct. 31 [cited 2025 Sep. 1];12(4):364-71. Available from: https://revcorsalud.sld.cu/index.php/cors/article/view/732

Issue

Vol. 12 No. 4 (2020)

Section

ORIGINAL ARTICLES

License

Authors who publish with this journal agree to the following terms:

    1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
    2. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.