Document Detail

Relation of ejection fraction and inducible ventricular tachycardia to mode of death in patients with coronary artery disease: an analysis of patients enrolled in the multicenter unsustained tachycardia trial.
MedLine Citation:
PMID:  12417544     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Fifty percent of deaths in patients with coronary disease occur suddenly. Although many factors correlate with increased mortality, there is little information regarding the influence of these factors on mode of death. As such, optimum methods to determine patients most likely to benefit from implantable defibrillator therapy are unclear. METHODS AND RESULTS: We analyzed the relation of ejection fraction and inducible ventricular tachyarrhythmias to mode of death in all 1791 patients enrolled in the Multicenter Unsustained Tachycardia Trial who did not receive antiarrhythmic therapy. Total mortality and arrhythmic deaths/cardiac arrests occurred more frequently in patients with ejection fraction <30% than in those with ejection fraction of 30% to 40%. The percentage of deaths classified as arrhythmic was similar in patients with ejection fraction <30% or > or =30%. The relative contribution of arrhythmic events to total mortality was significantly higher in patients with inducible tachyarrhythmia (58% of deaths in inducible patients versus 46% in noninducible patients, P=0.004). The higher percentage of events that were arrhythmic among patients with inducible tachyarrhythmia appeared more distinct among patients with an ejection fraction > or =30% (61% of events were arrhythmic among inducible patients with ejection fraction > or =30% and only 42% among noninducible patients, P=0.002). CONCLUSIONS: Both low ejection fraction and inducible tachyarrhythmias identify patients with coronary disease at increased mortality risk. Ejection fraction does not discriminate between modes of death, whereas inducible tachyarrhythmia identifies patients for whom death, if it occurs, is significantly more likely to be arrhythmic, especially if ejection fraction is > or =30%.
Alfred E Buxton; Kerry L Lee; Gail E Hafley; D George Wyse; John D Fisher; Michael H Lehmann; Luis A Pires; Michael R Gold; Douglas L Packer; Mark E Josephson; Eric N Prystowsky; Mario R Talajic;
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Circulation     Volume:  106     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2002 Nov 
Date Detail:
Created Date:  2002-11-05     Completed Date:  2002-11-12     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2466-72     Citation Subset:  AIM; IM    
Brown Medical School, Providence, RI, USA.
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MeSH Terms
Canada / epidemiology
Cardiac Pacing, Artificial
Chronic Disease
Coronary Artery Disease / mortality*,  physiopathology,  therapy
Death, Sudden, Cardiac / epidemiology,  etiology*
Defibrillators, Implantable
Electrophysiologic Techniques, Cardiac
Multicenter Studies as Topic / statistics & numerical data
Proportional Hazards Models
Randomized Controlled Trials as Topic / statistics & numerical data
Risk Assessment
Risk Factors
Stroke Volume*
Survival Rate
Tachycardia, Ventricular / mortality*,  physiopathology,  therapy
United States / epidemiology
Grant Support
Comment In:
Circulation. 2002 Nov 5;106(19):e9047-8   [PMID:  12417556 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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