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Accumulation of risk markers predicts the incidence of sudden death in patients with chronic heart failure
Author(s) -
Watanabe Jun,
Shinozaki Tsuyoshi,
Shiba Nobuyuki,
Fukahori Kohei,
Koseki Yoshito,
Karibe Akihiko,
Sakuma Masahito,
Miura Masahito,
Kagaya Yutaka,
Shirato Kunio
Publication year - 2006
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1016/j.ejheart.2005.08.003
Subject(s) - medicine , hazard ratio , heart failure , cardiology , ejection fraction , sudden death , proportional hazards model , sudden cardiac death , diabetes mellitus , confidence interval , ventricular tachycardia , endocrinology
Abstract Background: Sudden death is common in chronic heart failure (CHF). Risk stratification is the first step for primary prevention. Aim: To evaluate the use of risk markers for estimating sudden death risk. Methods and results: We prospectively examined 680 stable patients with CHF. Risk markers were evaluated using the Cox's proportional hazard model in a stepwise manner. Ejection fraction <30%, left ventricular end‐diastolic diameter >60 mm, brain natriuretic peptide >200 pg/ml, non‐sustained ventricular tachycardia, and diabetes were significantly associated with increased risk of sudden death. When the number of risk markers were included as co‐variables, only “number of risk markers ≥3” entered the model (hazard ratio 8.95, 95% confidence interval 4.57–17.52), while the effects of individual markers did not enter the model. The annual mortality from sudden death was 11% in patients with 3 or more risk markers and 1.4% in patients with 2 or less. Conclusions: Rather than particular risk markers, the number of accumulated risk markers was a more powerful predictor for sudden death in patients with CHF. The number of risk markers could be useful for risk stratification of sudden death.