Sudden Cardiac Death in Heart Failure: A 20-Year Perspective From a Mediterranean Cohort.
Mediterranean basin
Sudden cardiac death
risk model
Journal
Journal of cardiac failure
ISSN: 1532-8414
Titre abrégé: J Card Fail
Pays: United States
ID NLM: 9442138
Informations de publication
Date de publication:
03 2023
03 2023
Historique:
received:
15
07
2022
revised:
22
11
2022
accepted:
28
11
2022
pubmed:
16
12
2022
medline:
21
3
2023
entrez:
15
12
2022
Statut:
ppublish
Résumé
The prediction of sudden cardiac death (SCD) in heart failure (HF) remains an unmet need. The aim of our study was to assess the prevalence of SCD over 20 years in outpatients with HF managed in a Mediterranean multidisciplinary HF Clinic, and to compare the proportion of SCD (SCD/all-cause death) to the expected proportional occurrence based on the validated Seattle Proportional Risk Model (SPRM) score. This prospective observational registry study included 2772 outpatients with HF admitted between August 2001 and May 2021. Patients were included when the cause of death was known and SPRM score was available. Over the 20-year study period, 1351 patients (48.7%) died during a median follow-up period of 3.8 years (interquartile range 1.6-7.6). Among these patients, the proportion of SCD out of the total of deaths was 13.6%, whereas the predicted by SPRM was 39.6%. This lower proportion of SCD was observed independently of left ventricular ejection fraction, ischemic etiology, and the presence of an implantable cardiac defibrillator. In a Mediterranean cohort of outpatients with HF, the proportion of SCD was lower than expected based on the SPRM score. Future studies should investigate to what extend epidemiological and guideline-directed medical therapy patterns influence SCD.
Sections du résumé
BACKGROUND
The prediction of sudden cardiac death (SCD) in heart failure (HF) remains an unmet need. The aim of our study was to assess the prevalence of SCD over 20 years in outpatients with HF managed in a Mediterranean multidisciplinary HF Clinic, and to compare the proportion of SCD (SCD/all-cause death) to the expected proportional occurrence based on the validated Seattle Proportional Risk Model (SPRM) score.
METHODS AND RESULTS
This prospective observational registry study included 2772 outpatients with HF admitted between August 2001 and May 2021. Patients were included when the cause of death was known and SPRM score was available. Over the 20-year study period, 1351 patients (48.7%) died during a median follow-up period of 3.8 years (interquartile range 1.6-7.6). Among these patients, the proportion of SCD out of the total of deaths was 13.6%, whereas the predicted by SPRM was 39.6%. This lower proportion of SCD was observed independently of left ventricular ejection fraction, ischemic etiology, and the presence of an implantable cardiac defibrillator.
CONCLUSIONS
In a Mediterranean cohort of outpatients with HF, the proportion of SCD was lower than expected based on the SPRM score. Future studies should investigate to what extend epidemiological and guideline-directed medical therapy patterns influence SCD.
Identifiants
pubmed: 36521725
pii: S1071-9164(22)01222-2
doi: 10.1016/j.cardfail.2022.11.016
pii:
doi:
Types de publication
Observational Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
236-245Informations de copyright
Copyright © 2022 Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest A.B.-G. received speaker fees from Novartis. J.N. received speaker fees from Novartis, Vifor Pharma, Boehringer Ingelheim, Astra Zeneca, Rovi, and Novonordisk. P.C. and E. S. received speaker fees from Novartis. A.B.-G. and J.L. report a relationship with Critical Diagnostics. W.L. is in the steering committee for Respircardia and Cardiac Dimensions, clinical event committees for Abbott, EBR Systems, Beckman Coulter (NTproBNP), and Siemens (NTproBNP). He has a grant support from Medtronic and is a consultant to Medtronic and Impulse Dynamics. University of Washington holds the copyright to the SPRM.