Prediction of sudden cardiac death after acute myocardial infarction:: role of Holter monitoring in the modern treatment era
Prediction of sudden cardiac death after acute myocardial infarction:: role of Holter monitoring in the modern treatment era
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DOI：
10.1093/eurheartj/ehi188
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发表时间：
2005-04-01
影响因子：
39.3
通讯作者：
Huikuri, HV
中科院分区：
文献类型：
--
作者：
Mäkikallio, TH;Barthel, P;Huikuri, HV
目前的治疗可能改变了急性心肌梗死（AMI）幸存者的风险状况。我们评估了效用的霍尔特为基础的风险变量在预测心脏性猝死（SCD）与现代therapeutic.Methods和结果AMI的幸存者治疗共2130例AMI患者（平均年龄59 - 10岁）。这些患者接受了现代治疗策略，例如，94%的患者接受了β受体阻滞治疗，70%的患者接受了冠状动脉血运重建术。分析了霍尔特监测的各种风险参数。在中位随访1012天（四分位距：750-1416天）期间，心源性死亡率为113/2130，包括52例SCD。所有的霍尔特参数都能预测SCD的发生（P < 0.01），但在校正年龄、糖尿病和射血分数（EF）后，只有降低的异位湍流后斜率（TS）（P < 0.001）和非持续性室性心动过速（P < 0.01）仍然是SCD的显著预测因子。在亚组分析中，没有一个霍尔特变量可以预测EF患者的SCD
Aims Current treatment may have changed the risk profiles of survivors of acute myocardial infarction (AMI). We evaluated the utility of Holter based risk variables in the prediction of sudden cardiac death (SCD) among survivors of AMI treated with modern therapy.Methods and results A total of 2130 AMI patients (mean age 59 10 years) were included. The patients were treated with modern therapeutic strategies, for example, 94% were on beta-blocking therapy and 70% underwent coronary revascularization. Various risk parameters from Holter monitoring were analysed. During a median follow-up of 1012 days (interquartile range: 750-1416 days), cardiac mortality was 113/2130, including 52 SCDs. All Holter variables predicted the occurrence of SCD (P < 0.01), but only reduced post-ectopic turbulence slope (TS) (P < 0.001) and non-sustained ventricular tachycardia (P < 0.01) remained as marked SCD predictors after adjustment for age, diabetes, and ejection fraction (EF). In a subgroup analysis, none of the Holter variables predicted SCD among those with an EF