Accumulation of risk markers predicts the incidence of sudden death in patients with chronic heart failure.

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 >or=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.

• Authors: Jun Watanabe, Tsuyoshi Shinozaki, Nobuyuki Shiba, Kohei Fukahori, Yoshito Koseki, Akihiko Karibe, Masahito Sakuma, Masahito Miura, Yutaka Kagaya, Kunio Shirato
• Journal: European journal of heart failure (Eur J Heart Fail) Vol. 8 Issue 3 Pg. 237-42 (May 2006) ISSN: 1388-9842 [Print] England
• PMID: 16185924 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adult
• Aged
• Death, Sudden (etiology)
• Diastole
• Female
• Heart Failure (complications, physiopathology)
• Humans
• Incidence
• Male
• Middle Aged
• Prospective Studies
• Risk
• Stroke Volume
• Ventricular Function, Left