Document Detail

Prevention of sudden cardiac death: lessons from recent controlled trials.
MedLine Citation:
PMID:  15914936     Owner:  NLM     Status:  MEDLINE    
Sudden cardiac death (SCD), presumably because of ventricular tachyarrhythmias, remains one of the major challenges of contemporary cardiology. Major randomized controlled trials conducted in patients with coronary artery disease (CAD) with the aim of primary prevention of SCD are providing insights. Several large-scale studies have demonstrated that treatment with beta-blockers, angiotensin-converting enzyme inhibitors, aldosterone antagonists, and statins results not only in a reduction in all-cause mortality but specifically also in SCD. On top of this optimized pharmacological therapy, implantable cardioverter-defibrillators (ICD) further decrease the risk of overall and SCD mortality in carefully selected patient groups. The sum of these trials indicates, however, that the benefit associated with ICD therapy is most prominent in patients with chronic stable CAD. In contrast, patients early after myocardial infarction derive less benefit from ICD treatment, presumably because of a high competing risk of non-arrhythmic cardiovascular death. Optimized pharmacological therapy, together with the ICD, can substantially improve the prognosis of high-risk CAD patients.
Sergio Richter; Gabor Duray; Gerian Grönefeld; Carsten W Israel; Stefan H Hohnloser
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  69     ISSN:  1346-9843     ISO Abbreviation:  Circ. J.     Publication Date:  2005 Jun 
Date Detail:
Created Date:  2005-05-25     Completed Date:  2005-09-01     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  625-9     Citation Subset:  IM    
JW Goethe Universität, Frankfurt am Main, Germany.
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MeSH Terms
Coronary Artery Disease / complications,  drug therapy*,  mortality
Death, Sudden, Cardiac / etiology,  prevention & control*
Randomized Controlled Trials as Topic
Risk Factors
Tachycardia, Ventricular* / complications,  mortality

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