Risk factors for mortality in post-myocardial infarction patients: insights from the improve SCA bridge study
Journal
The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology
Journal Volume
76
Journal Issue
1
ISSN
2090-911X
Date Issued
2024-06-07
Author(s)
Kumar, Dileep
Bardooli, Fawaz
Huang, Dejia
Sankardas, Mullasari Ajit
Ahmed, Waqar Habib
Liew, Houng-Bang
Gwon, Hyeon-Cheol
Van Dorn, Brian
Holmes, Thomas
Thompson, Amy
Zhang, Shu
DOI
10.1186/s43044-024-00505-2
Abstract
Background: Underutilization of implantable cardioverter defibrillators (ICD) to prevent sudden cardiac death (SCD) in post-myocardial infarction (MI) patients remains an issue across several geographies. A better understanding of risk factors for SCD in post-MI patients from regions with low ICD adoption rates will help identify those who will benefit from an ICD. This analysis assessed risk factors for all-cause and cardiovascular-related mortality in post-MI patients from the Improve Sudden Cardiac Arrest (SCA) Bridge Trial.
Results: For the entire cohort, the overall 1-year mortality rate was 5.9% (88/1491) and 3.4% (51/1491) for all-cause and cardiovascular mortality, respectively, with 76.5% of all cardiac deaths being from SCD. A multivariate model determined increased age, reduced left ventricular ejection fraction (LVEF), increased time from myocardial infarction to hospital admission, being female, being from Southeast Asia (SEA), and having coronary artery disease to be significant risk factors for all-cause mortality. The risk factors for cardiovascular-related mortality revealed increased age, reduced LVEF, and being from SEA as significant risk factors.
Conclusions: We show several characteristics as being predictors of cardiovascular-related mortality in post-MI patients from the Improve SCA Bridge study. Patients who experience an MI and present with these characteristics would benefit from a referral to an electrophysiologist for further SCD risk stratification and management and possible subsequent ICD implantation to reduce unnecessary death.
Subjects
Implantable cardioverter-defibrillator
Ischemic vs non-ischemic cardiomyopathy
Sudden cardiac death
Description
Article number 72
Type
journal article