TAILIEUCHUNG - Sudden Death in Patients with Myocardial Infarction and Left Ventricular Dysfunction, Heart Failure, or Both

The risk of sudden death from cardiac causes is increased among survivors of acute myocardial infarction with reduced left ventricular systolic function. We assessed the risk and time course of sudden death in high-risk patients after myocardial infarction. methods We studied 14,609 patients with left ventricular dysfunction, heart failure, or both after myocardial infarction to assess the incidence and timing of sudden unexpected death or cardiac arrest with resuscitation in relation to the left ventricular ejection fraction | Sudden Death in Patients with Myocardial Infarction and Left Ventricular Dysfunction Heart Failure or Both Sudden Death in Patients with Myocardial Infarction and Left Ventricular Dysfunction Heart Failure or Both Scott D. Solomon . Steve Zelenkofske . John . McMurray . Peter V. Finn . Eric Velazquez . George Ertl . Adam Harsanyi . Jean L. Rouleau . Aldo Maggioni . Lars Kober . Harvey White . Frans Van de Werf . . Karen Pieper . Robert M. Califf . and Marc A. Pfeffer . . for the Valsartan in Acute Myocardial Infarction Trial VALIANT Investigators abstract background The risk of sudden death from cardiac causes is increased among survivors of acute myocardial infarction with reduced left ventricular systolic function. We assessed the risk and time course of sudden death in high-risk patients after myocardial infarction. methods We studied 14 609 patients with left ventricular dysfunction heart failure or both after myocardial infarction to assess the incidence and timing of sudden unexpected death or cardiac arrest with resuscitation in relation to the left ventricular ejection fraction. results Of14 609 patients 1067 7 percent had an event a median of 180 days after myocardial infarction 903 died suddenly and 164 were resuscitated after cardiac arrest. The risk was highest in the first 30 days after myocardial infarction percent per month 95 percent confidence interval to percent and decreased to percent per month 95 percent confidence interval to percent after 2 years. Patients with a left ventricular ejection fraction of 30 percent or less were at highest risk in this early period rate percent per month 95 percent confidence interval to percent . Nineteen percent ofall sudden deaths or episodes of cardiac arrest with resuscitation occurred within the first 30 days after myocardial infarction and 83 percent ofall patients who died suddenly did so in the first 30 days .

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