Can sudden death be predicted after myocardial infarcts?
Keywords:
SUDDEN CARDIAC DEATH, MYOCARDIAL INFARCTION, RISK STRATIFICATION
Abstract
Sudden death is responsible of more than half of cardiac related death. Prediction of patients at high risk of sudden death has improved but more than 90% of deaths coincide with unidentifying risk factors free-people. More over, we know that most of them present a previous coronary disease and also that cardiac sudden death is essentially an extrahospitalarian problem.
Myocardial arrest is a factor to easily detect groups with high mortality rates. Mortality rates after myocardial infarction range from 5 to 11%, within six to 12 months after release and 20% at five years. Although many markers have been identifying, their predictor value is relatively low. Specific markers were described and reviewed to stratify sudden death risks; left ventricular disfunction is one of the principal marker; others as follow: clinical, based on images, autonomics and electrocardiographics, besides biomarkers, invasive and combined methods.
Risk stratification is designed according to clinical history, functional class and left ventricular ejection fraction (LVEF/FEVI).
At first, patients at high risk should receive beta-blockers, enzyme converted inhibitors, spironolactone and antithrombotics. In many cases, cardiodefibrillator implantation should be considered.
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Vanerio Balbela G, Vidal Amaral JL, Fernández Banizi P, López Achigar G, Banina Aguerre D, Viana P, Vanerio de León A, Bagattini JC. Can sudden death be predicted after myocardial infarcts?. Rev. Méd. Urug. [Internet]. 2006Dec.31 [cited 2024Nov.17];22(4):249-65. Available from: http://www2.rmu.org.uy/ojsrmu311/index.php/rmu/article/view/658
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