| Syncope predicts the outcome of cardiomyopathy patients: analysis of the SCD-HeFT study. | |
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MedLine Citation:
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PMID: 18371559 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: The outcome of congestive heart failure (CHF) patients with syncope is understood incompletely. BACKGROUND: We analyzed data from patients enrolled in the SCD-HeFT (Sudden Cardiac Death Heart Failure Trial) to determine whether syncope predicted outcomes in patients with CHF. METHODS: We compared outcomes (and associated clinical characteristics) in patients with and without syncope enrolled in SCD-HeFT. RESULTS: In SCD-HeFT, 162 (6%) patients had syncope before randomization, 356 (14%) had syncope after randomization (similar incidence in each randomized arm), and 46 (2%) had syncope before and after randomization. A QRS duration >or=120 ms and absence of beta-blocker use predicted syncope during follow-up (hazard ratio [HR] 1.30 and 95% confidence interval [CI] 1.06 to 1.61, p = 0.014 and HR 1.25, 95% CI 1.01 to 1.56, p = 0.048, respectively). Syncope recurrence did not differ by randomization arm. However, in the implantable cardioverter-defibrillator (ICD) arm, syncope, before and after randomization, was associated with appropriate ICD discharges (HR 1.75, 95% CI 1.10 to 2.80, p = 0.019 and HR 2.91, 95% CI 1.89 to 4.47, p = 0.001, respectively). Post-randomization syncope predicted total and cardiovascular death (HR 1.41, 95% CI 1.13 to 1.76, p = 0.002 and HR 1.55, 95% CI 1.19 to 2.02, p = 0.001, respectively). The elevated relative risk of mortality for syncope versus non-syncope patients did not vary significantly across treatment arms (ICD, HR 1.54, 95% CI 1.04 to 2.27; amiodarone, HR 1.33, 95% CI 0.91 to 1.93; and placebo, HR 1.39, 95% CI 0.96 to 2.02, test for difference p = 0.86). CONCLUSIONS: For CHF patients with ICDs, syncope was associated with appropriate ICD activations. Syncope was associated with increased mortality risk in SCD-HeFT regardless of treatment arm (placebo, amiodarone, or ICD). |
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Authors:
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Brian Olshansky; Jeanne E Poole; George Johnson; Jill Anderson; Anne S Hellkamp; Douglas Packer; Daniel B Mark; Kerry L Lee; Gust H Bardy; |
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Publication Detail:
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Type: Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 51 ISSN: 1558-3597 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2008 Apr |
Date Detail:
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Created Date: 2008-03-28 Completed Date: 2008-04-29 Revised Date: 2008-05-16 |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 1277-82 Citation Subset: AIM; IM |
Affiliation:
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University of Iowa, Iowa City, Iowa, USA. brian-olshansky@uiowa.edu |
| Data Bank Information | |
Bank Name/Acc. No.:
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ClinicalTrials.gov/NCT00000609 |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Amiodarone / therapeutic use* Anti-Arrhythmia Agents / therapeutic use* Cardiomyopathies / drug therapy*, mortality Death, Sudden, Cardiac* / etiology, prevention & control Defibrillators, Implantable Female Health Status Heart Failure / drug therapy*, mortality Humans Male Middle Aged Myocardial Ischemia / drug therapy*, mortality Predictive Value of Tests Prognosis Recurrence Risk Risk Factors Stroke Volume Syncope / mortality* Time Factors Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Anti-Arrhythmia Agents; 1951-25-3/Amiodarone |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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