| Predictors of sudden cardiac death change with time after myocardial infarction: results from the VALIANT trial. | |
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MedLine Citation:
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PMID: 19854729 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIMS: To determine whether predictors of sudden cardiac death (SCD) vary with time after myocardial infarction (MI). METHODS AND RESULTS: We analysed 11 256 patients enrolled in VALIANT. Landmark analysis and Cox proportional hazards modelling were used to predict SCD during hospitalization, from discharge to 30 days, 30 days to 6 months, and 6 months to 3 years. The cumulative incidence of SCD was 8.6% (n = 965). Initially, higher baseline heart rate [HR 1.20 per 10 b.p.m. (95% CI 1.06-1.37)] and impaired baseline creatinine clearance [HR 0.82 per 10 mL/min (95% CI 0.74-0.91)] were stronger predictors of SCD. With long-term follow-up, prior MI [HR 1.71 (95% CI 1.39-2.10)], initial left ventricular ejection fraction <40% [HR 0.67 per 10% (95% CI 0.58-0.78)], and recurrent cardiovascular events [HR 1.47 for rehospitalization (95% CI 1.17-1.86)] were more robust risk stratifiers for SCD. Atrial fibrillation post-MI was associated with an increased risk of SCD over the entire follow-up period. As time passed, the associations between baseline clinical characteristics and SCD decreased and time-updated assessments became more important. CONCLUSION: Predictors of SCD change with time after MI. Future studies of risk stratification for SCD should account for changes in these factors with time after MI. |
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Authors:
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Jonathan P Piccini; Min Zhang; Karen Pieper; Scott D Solomon; Sana M Al-Khatib; Frans Van de Werf; Marc A Pfeffer; John J V McMurray; Robert M Califf; Eric J Velazquez |
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Publication Detail:
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Type: Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't Date: 2009-10-23 |
Journal Detail:
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Title: European heart journal Volume: 31 ISSN: 1522-9645 ISO Abbreviation: Eur. Heart J. Publication Date: 2010 Jan |
Date Detail:
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Created Date: 2010-01-15 Completed Date: 2011-01-11 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8006263 Medline TA: Eur Heart J Country: England |
Other Details:
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Languages: eng Pagination: 211-21 Citation Subset: IM |
Affiliation:
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Division of Cardiology, Duke Clinical Research Institute, Duke University Medical Center, Durham, NC 27705, USA. jonathan.piccini@duke.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Angiotensin-Converting Enzyme Inhibitors / therapeutic use Captopril / therapeutic use Death, Sudden, Cardiac / etiology* Double-Blind Method Female Hospitalization Humans Male Middle Aged Myocardial Infarction / drug therapy*, physiopathology Proportional Hazards Models Recurrence Risk Factors Stroke Volume / physiology Tetrazoles / therapeutic use Time Factors Valine / analogs & derivatives, therapeutic use Ventricular Dysfunction, Left / etiology |
| Chemical | |
Reg. No./Substance:
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0/Angiotensin-Converting Enzyme Inhibitors; 0/Tetrazoles; 137862-53-4/valsartan; 62571-86-2/Captopril; 7004-03-7/Valine |
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