Main Predictors of Sudden Cardiac Death in Patients with Q-Wave Myocardial Infarction

ORIGINAL ARTICLE
Ravshanbek D Kurbanov, PhD, ScD; Guzal U. Mullabaeva, PhD*; Anvar A Kilichev

The Republican Specialized Center of Cardiology; Tashkent, Uzbekistan

*Corresponding author: Guzal U. Mullabaeva, PhD. The Republican Specialized Center of Cardiology; Tashkent, Uzbekistan. E-mail: anchomed@gmail.com

Published: December 3, 2015. DOI: 10.21103/Article5(4)_OA5

Abstract: 

The study included 131 patients (mean age 51.9±9.13 year) with Q-wave myocardial infarction (Q-MI). All patients underwent echocardiography and 24-hour ECG monitoring on the 10th through the 14th days of MI. Treatment included thrombolytic therapy, early administration of beta-blockers, antiplatelet agents, anticoagulants, statins, ACE inhibitors, if needed - antiarrhythmics and aldosterone antagonists. Follow-up was 24 months. During the observation period, of the 131 study patients 17(13.0%) died suddenly. Our study suggests that the high risk of SCD (in the first 2 years after MI) in patients with Q-MI is associated with anterior localization, early pathological LV remodeling, low myocardial contractility, and development of AHF high Killip classes in the early period of MI, as well as the identification of high heart rate  at rest, frequent PVCs (mainly polymorphic), systolic dysfunction in the early stages of observation (on the 10th through the 14th days), and older age of patients.

Keywords: 
sudden cardiac death (SCD); myocardial infarction (MI); premature ventricular contractions (PVCs).
References: 
  1. Bokeria OL, Akhobekov AA. Sudden cardiac death: mechanisms and risk stratification. Ann Aritm 2012; 3:5-13. [Article in Russian].
  2. Bokeria LA, Bokeria OL, Kirtbaya LN. Heart failure and sudden cardiac death. Ann Aritm 2009; 4:7-20. [Article in Russian].
  3. Bokeria LA, Revishvili AS. Sudden cardiac death. M.: GEO-TAP-Media; 2011. [Manual in Russian].
  4.  Boldueva SA, Shabrov AV, Lebedev DS, Burak Tatyana Leonova IA, Samohvalova MV, Beetle VS, Bykov EG. Prediction and prevention of sudden cardiac death in patients with myocardial infarction. Kardiov Ter Prof 2008; 7(3):56-62. [Article in Russian].
  5. Kurbanov RD. Ventricular arrhythmias. Tashkent; 2012. [Monograph in Russian].
  6.  Kurbanov RD, Kiyakbaev GK. Myocardial infarction. Life expectancy. Tashkent; 2001. [Monograph in Russian].
  7. Goldstein S, Medendorp SV, Landis JR, Wolfe RA, LeigttonR, Ritter G, et al. Analysis of cardiac symptoms preceding cardiac arrest. Am J Cardiol 1986; 58(13):1195-8.
  8.  Epstein AE, DiMarco JP, Ellenbogen KA, Estes NA 3rd, Freedman RA, Gettes LS, et al. ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices): developed in collaboration with the American Association for Thoracic Surgery and Society of Thoracic Surgeons. Circulation 2008; 117(21):e350-408.
  9.  Goldberger JJ, Buxton AE, Cain M, Costantini O, Exner DV, Knight BP, et al. Risk stratification for arrhythmic sudden cardiac death: identifying the roadblocks. Circulation 2011; 123(21): 2423-30.
  10. Trappe HJ, Brugada P, Talajic M, Lezaun R, Wellens HJ. Ventricular tachycardia and ventricular fibrillation following myocardial infarct: determinants of prognosis and disease course. Z Kardiol 1988; 77(11):687-95. [Article in German].
  11.  Stecker EC, Vickers C, Waltz J, Socoteanu C, John BT, Mariani R, et al. Population-based analysis of sudden cardiac death with and without left ventricular systolic dysfunction: two-year findings from the Oregon Sudden Unexpected Death Study. J Am Coll Cardiol 2006; 47(6):1161-6.
  12.  Maggioni AP, Zuanetti G, Franzosi MG, Rovelli F, Santoro E, Staszewsky L, et al. Prevalence and prognostic significance of ventricular arrhythmias after acute myocardial infarction in the fibrinolytic era. GISSI-2 results. Circulation 1993; 87:312–22.

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Int J Biomed. 2015; 5(4):195-197. © 2015 International Medical Research and Development Corporation. All rights reserved.