Comparison of risk profiles between survivors and victims of sudden cardiac death from an acute coronary event

Figures & data

Table

AMI	acute myocardial infarction
BMI	body mass index
BSA	body surface area
CAD	coronary artery disease
CI	confidence interval
LVM	left ventricular mass
OR	odds ratio
SCD	sudden cardiac death
THW	total heart weight

Table I.  Characteristics of the study subjects.

	Victims of SCD n=425	Survivors of AMI n=644	P
Age, y	64.2 (±11.3)	62.3 (±10.0)	–
Gender (male)	356/425 (83.8)	480/644 (74.5)	<0.001
BMI	27.2 (±4.6)	27.5 (±4.0)	0.16
Smoking status			<0.001
Never	92/292 (31.5)	203/626 (32.4)
Ex	65/292 (22.3)	234/626 (37.2)
Current	135/292 (46.2)	189/626 (30.2)
Hypercholesterolemia	113/418 (27.0)	392/587 (66.8)	<0.001
Diabetes type I or II	74/419 (17.7)	147/633 (23.2)	0.03
Hypertension	208/417 (49.9)	319/635 (50.2)	0.95
Angina pectoris	209/413 (50.6)	330/633 (52.1)	0.66
History of myocardial infarction	60/419 (14.3)	136/635 (20.5)	0.04
Family history of SCD	79/246 (32.1)	79/332 (23.8)	0.03
Family history of AMI	104/227 (45.8)	170/332 (51.2)	0.23
Cardiac hypertrophy	295/420 (70.2)	270/614 (44.0)	<0.001
Critical stenosis (>75%) in			<0.001
No critical stenosis	45/423 (10.6)	23/225 (10.2)
One coronary artery	85/423 (20.1)	111/225 (49.3)
Two coronary arteries	93/423 (22.0)	59/225 (26.2)
Three coronary arteries	200/423 (47.3)	32/225 (14.2)
Location of stenosis ^a
Left main	3/82 (3.7)	1/111 (0.9)	0.31
Left anterior descending	48/82 (58.5)	52/111 (46.8)	0.11
Left circumflex	7/82 (8.5)	18/111 (16.2)	0.13
Right coronary artery	26/82 (31.7)	41/111 (36.9)	0.54

^a Subjects with critical stenosis in one coronary artery.

Due to previously used exclusion criterion of advanced age (>75 years) in AMI population, no statistical comparison for age was performed 4.

Values are expressed as mean (±SD) or number of subjects (%). Probability values refer to two-sided t test and chi-square analyses comparing victims of SCD to survivors of AMI.

SCD=sudden cardiac death; AMI=acute myocardial infarct; BMI=body mass index.

Figure 1.  Odds ratios for the combinations of risk factors showing the risk of sudden cardiac death from an acute coronary event. SCD=sudden cardiac death; CI=95% confidence interval.

Table II.  Sensitivity, specificity, and predictive accuracy of the risk factors. Values are expressed as% (95% confidence interval).

	Sensitivity	Specificity	PPV	NPV
Family history of SCD	32 (26–38)	76 (72–81)	50 (42–58)	60 (56–65)
Male gender	84 (80–87)	25 (22–29)	43 (39–46)	70 (66–76)
Current smoking	46 (41–52)	70 (66–73)	42 (36–47)	74 (70–77)
Cardiac hypertrophy	70 (66–75)	56 (52–60)	52 (48–56)	73 (69–77)
Three-vessel CAD	47 (43–52)	86 (81–90)	86 (82–91)	46 (42–51)
Combination 1^a	80 (71–89)	51 (42–61)	55 (46–64)	77 (68–87)
Combination 2^b	72 (68–87)	74 (62–85)	63 (49–78)	81 (70–92)
Combination 3^c	88 (74–100)	86 (72–100)	88 (74–100)	86 (74–100)
Combination 4^d	100 (95–100)	100 (95–100)	100 (95–100)	100 (95–100)

^aFamily history of SCD and male gender.

^bFamily history of SCD, male gender, and current smoking.

^cFamily history of SCD, male gender, current smoking and cardiac hypertrophy.

^dFamily history of SCD, male gender, current smoking, cardiac hypertrophy and three-vessel CAD.

Combinations 1, 2, 3, and 4 represent 26% (n=64/246), 11% (n=26/230), 9% (n=21/229), and 7% (n=15/228) of SCD population for whom there was complete information about each variable in the combination, respectively.

CAD=coronary artery disease; NPV=negative predictive value; PPV=positive predictive value; SCD=sudden cardiac death.

Tapanainen JM, Still AM, Airaksinen KE, Huikuri HV. Prognostic significance of risk stratifiers of mortality, including T wave alternans, after acute myocardial infarction: results of a prospective follow-up study. J Cardiovasc Electrophysiol. 2001; 12: 645–52

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