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Usefulness of the Duke Sudden Cardiac Death risk score for predicting sudden cardiac death in patients with angiographic (>75% narrowing) coronary artery disease.

Publication ,  Journal Article
Atwater, BD; Thompson, VP; Vest, RN; Shaw, LK; Mazzei, WR; Al-Khatib, SM; Hranitzky, PM; Bahnson, TD; Velazquez, EJ; Califf, RM; Lee, KL; Roe, MT
Published in: Am J Cardiol
December 15, 2009

The currently available sudden cardiac death (SCD) risk prediction tools fail to identify most at-risk patients and cannot delineate a specific patient's SCD risk. We sought to develop a tool to improve the risk stratification of patients with coronary artery disease. Clinical, demographic, and angiographic characteristics were evaluated among 37,258 patients who had undergone coronary angiography from January 1, 1985 to May 31, 2005, and who were found to have at least one native coronary artery stenosis of > or =75%. After a median follow-up of 6.2 years, SCD had occurred in 1,568 patients, 14,078 patients had died from other causes, and 21,612 patients remained alive. A Cox proportional hazards model identified 10 independent patient characteristic variables significantly associated with SCD. A simplified model accounting for 97% of the predictive capacity of the full model included the following 7 variables: depressed left ventricular ejection fraction, number of diseased coronary arteries, diabetes mellitus, hypertension, heart failure, cerebrovascular disease, and tobacco use. The Duke SCD risk score was created from the simplified model to predict the likelihood of SCD among patients with coronary artery disease. It was internally validated with bootstrapping (c-index = 0.75, chi-square = 1,220.8) and externally validated in patients with ischemic cardiomyopathy from the Sudden Cardiac Death Heart Failure Trial (SCD-HeFT) database (c-index = 0.64, chi-square = 14.1). In conclusion, the Duke SCD risk score represents a simple, validated method for predicting the risk of SCD among patients with coronary artery disease and might be useful for directing treatment strategies designed to mitigate the risk of SCD.

Duke Scholars

Published In

Am J Cardiol

DOI

EISSN

1879-1913

Publication Date

December 15, 2009

Volume

104

Issue

12

Start / End Page

1624 / 1630

Location

United States

Related Subject Headings

  • Risk Factors
  • Risk Assessment
  • Predictive Value of Tests
  • Middle Aged
  • Male
  • Humans
  • Female
  • Death, Sudden, Cardiac
  • Coronary Artery Disease
  • Coronary Angiography
 

Citation

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Atwater, B. D., Thompson, V. P., Vest, R. N., Shaw, L. K., Mazzei, W. R., Al-Khatib, S. M., … Roe, M. T. (2009). Usefulness of the Duke Sudden Cardiac Death risk score for predicting sudden cardiac death in patients with angiographic (>75% narrowing) coronary artery disease. Am J Cardiol, 104(12), 1624–1630. https://doi.org/10.1016/j.amjcard.2009.07.042
Atwater, Brett D., Vivian P. Thompson, Richard N. Vest, Linda K. Shaw, Walter R. Mazzei, Sana M. Al-Khatib, Patrick M. Hranitzky, et al. “Usefulness of the Duke Sudden Cardiac Death risk score for predicting sudden cardiac death in patients with angiographic (>75% narrowing) coronary artery disease.Am J Cardiol 104, no. 12 (December 15, 2009): 1624–30. https://doi.org/10.1016/j.amjcard.2009.07.042.
Atwater BD, Thompson VP, Vest RN, Shaw LK, Mazzei WR, Al-Khatib SM, et al. Usefulness of the Duke Sudden Cardiac Death risk score for predicting sudden cardiac death in patients with angiographic (>75% narrowing) coronary artery disease. Am J Cardiol. 2009 Dec 15;104(12):1624–30.
Atwater, Brett D., et al. “Usefulness of the Duke Sudden Cardiac Death risk score for predicting sudden cardiac death in patients with angiographic (>75% narrowing) coronary artery disease.Am J Cardiol, vol. 104, no. 12, Dec. 2009, pp. 1624–30. Pubmed, doi:10.1016/j.amjcard.2009.07.042.
Atwater BD, Thompson VP, Vest RN, Shaw LK, Mazzei WR, Al-Khatib SM, Hranitzky PM, Bahnson TD, Velazquez EJ, Califf RM, Lee KL, Roe MT. Usefulness of the Duke Sudden Cardiac Death risk score for predicting sudden cardiac death in patients with angiographic (>75% narrowing) coronary artery disease. Am J Cardiol. 2009 Dec 15;104(12):1624–1630.
Journal cover image

Published In

Am J Cardiol

DOI

EISSN

1879-1913

Publication Date

December 15, 2009

Volume

104

Issue

12

Start / End Page

1624 / 1630

Location

United States

Related Subject Headings

  • Risk Factors
  • Risk Assessment
  • Predictive Value of Tests
  • Middle Aged
  • Male
  • Humans
  • Female
  • Death, Sudden, Cardiac
  • Coronary Artery Disease
  • Coronary Angiography