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Predictors of sudden cardiac death change with time after myocardial infarction: results from the VALIANT trial.

Publication ,  Journal Article
Piccini, JP; Zhang, M; Pieper, K; Solomon, SD; Al-Khatib, SM; Van de Werf, F; Pfeffer, MA; McMurray, JJV; Califf, RM; Velazquez, EJ
Published in: Eur Heart J
January 2010

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.

Duke Scholars

Published In

Eur Heart J

DOI

EISSN

1522-9645

Publication Date

January 2010

Volume

31

Issue

2

Start / End Page

211 / 221

Location

England

Related Subject Headings

  • Ventricular Dysfunction, Left
  • Valsartan
  • Valine
  • Time Factors
  • Tetrazoles
  • Stroke Volume
  • Risk Factors
  • Recurrence
  • Proportional Hazards Models
  • Myocardial Infarction
 

Citation

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Piccini, J. P., Zhang, M., Pieper, K., Solomon, S. D., Al-Khatib, S. M., Van de Werf, F., … Velazquez, E. J. (2010). Predictors of sudden cardiac death change with time after myocardial infarction: results from the VALIANT trial. Eur Heart J, 31(2), 211–221. https://doi.org/10.1093/eurheartj/ehp425
Piccini, Jonathan P., 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, and Eric J. Velazquez. “Predictors of sudden cardiac death change with time after myocardial infarction: results from the VALIANT trial.Eur Heart J 31, no. 2 (January 2010): 211–21. https://doi.org/10.1093/eurheartj/ehp425.
Piccini JP, Zhang M, Pieper K, Solomon SD, Al-Khatib SM, Van de Werf F, et al. Predictors of sudden cardiac death change with time after myocardial infarction: results from the VALIANT trial. Eur Heart J. 2010 Jan;31(2):211–21.
Piccini, Jonathan P., et al. “Predictors of sudden cardiac death change with time after myocardial infarction: results from the VALIANT trial.Eur Heart J, vol. 31, no. 2, Jan. 2010, pp. 211–21. Pubmed, doi:10.1093/eurheartj/ehp425.
Piccini JP, Zhang M, Pieper K, Solomon SD, Al-Khatib SM, Van de Werf F, Pfeffer MA, McMurray JJV, Califf RM, Velazquez EJ. Predictors of sudden cardiac death change with time after myocardial infarction: results from the VALIANT trial. Eur Heart J. 2010 Jan;31(2):211–221.
Journal cover image

Published In

Eur Heart J

DOI

EISSN

1522-9645

Publication Date

January 2010

Volume

31

Issue

2

Start / End Page

211 / 221

Location

England

Related Subject Headings

  • Ventricular Dysfunction, Left
  • Valsartan
  • Valine
  • Time Factors
  • Tetrazoles
  • Stroke Volume
  • Risk Factors
  • Recurrence
  • Proportional Hazards Models
  • Myocardial Infarction