Clinical and psychological factors affecting sudden death risk in myocardial infarction patients

Aim. To assess prognostic value of clinical and psychological factors in regard to sudden cardiac death (SCD) risk in patients after myocardial infarction (MI). Material and methods. In total, 420 patients were examined at Day 10-14 after MI; follow-up period lasted for 1-4 years. General clinical e...

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Main Authors: S. A. Boldueva, A. V. Shabrov, I. A. Leonova, T. Ya. Burak, M. V. Samokhvalova, O. V. Trofimova, E. G. Bykova, A. E. Gimgina
Format: Article
Language:Russian
Published: «SILICEA-POLIGRAF» LLC 1970-01-01
Series:Кардиоваскулярная терапия и профилактика
Subjects:
Online Access:https://cardiovascular.elpub.ru/jour/article/view/1482
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author S. A. Boldueva
A. V. Shabrov
I. A. Leonova
T. Ya. Burak
M. V. Samokhvalova
O. V. Trofimova
E. G. Bykova
A. E. Gimgina
author_facet S. A. Boldueva
A. V. Shabrov
I. A. Leonova
T. Ya. Burak
M. V. Samokhvalova
O. V. Trofimova
E. G. Bykova
A. E. Gimgina
author_sort S. A. Boldueva
collection DOAJ
description Aim. To assess prognostic value of clinical and psychological factors in regard to sudden cardiac death (SCD) risk in patients after myocardial infarction (MI). Material and methods. In total, 420 patients were examined at Day 10-14 after MI; follow-up period lasted for 1-4 years. General clinical examination, echocardiography, 24-hour electrocardiography (ECG) monitoring, late ventricular potentials (LVP) detection, active orthostatic test (AOT), heart rate variability (HRV) assessment, psychological testing, if necessary – coronary angiography and endocardial electrophysiological examination were performed. Results. In the first post-MI year, SCD incidence was 6,7%. SCD risk was predicted by anterior MI localization, left ventricular (LV) aneurysm, heart failure, pre-syncope in anamnesis, hypotension during AOT, sinus tachycardia, left bundle block, anxiety and depression symptoms, leukocytosis and monocytosis in acute AMI period, alcohol abuse in anamnesis, treatment features (no beta-adrenoblockers; diuretic therapy). In multivariate analysis, the most important clinical factors included previous MI, hypotension in AOT, LV ejection fraction, ventricular arrhythmias by 24-hour ECG monitoring, HRV and LVP assessment data. Conclusion. Due to high SCD rates in MI patients, SCD risk should be assessed as early as during hospitalization, using relevant clinical and psychological parameters. If needed, detailed examination and secondary SCD prevention measures should be performed.
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spelling doaj.art-7cbde52c4b2346a6a7c8c3e75954485d2024-10-17T12:21:21Zrus«SILICEA-POLIGRAF» LLCКардиоваскулярная терапия и профилактика1728-88002619-01251970-01-017759661200Clinical and psychological factors affecting sudden death risk in myocardial infarction patientsS. A. Boldueva0A. V. Shabrov1I. A. Leonova2T. Ya. Burak3M. V. Samokhvalova4O. V. Trofimova5E. G. Bykova6A. E. Gimgina7I.I. Mechnikov St. Petersburg State Medical Academy, St PetersburgI.I. Mechnikov St. Petersburg State Medical Academy, St PetersburgI.I. Mechnikov St. Petersburg State Medical Academy, St PetersburgI.I. Mechnikov St. Petersburg State Medical Academy, St PetersburgI.I. Mechnikov St. Petersburg State Medical Academy, St PetersburgI.I. Mechnikov St. Petersburg State Medical Academy, St PetersburgI.I. Mechnikov St. Petersburg State Medical Academy, St PetersburgI.I. Mechnikov St. Petersburg State Medical Academy, St PetersburgAim. To assess prognostic value of clinical and psychological factors in regard to sudden cardiac death (SCD) risk in patients after myocardial infarction (MI). Material and methods. In total, 420 patients were examined at Day 10-14 after MI; follow-up period lasted for 1-4 years. General clinical examination, echocardiography, 24-hour electrocardiography (ECG) monitoring, late ventricular potentials (LVP) detection, active orthostatic test (AOT), heart rate variability (HRV) assessment, psychological testing, if necessary – coronary angiography and endocardial electrophysiological examination were performed. Results. In the first post-MI year, SCD incidence was 6,7%. SCD risk was predicted by anterior MI localization, left ventricular (LV) aneurysm, heart failure, pre-syncope in anamnesis, hypotension during AOT, sinus tachycardia, left bundle block, anxiety and depression symptoms, leukocytosis and monocytosis in acute AMI period, alcohol abuse in anamnesis, treatment features (no beta-adrenoblockers; diuretic therapy). In multivariate analysis, the most important clinical factors included previous MI, hypotension in AOT, LV ejection fraction, ventricular arrhythmias by 24-hour ECG monitoring, HRV and LVP assessment data. Conclusion. Due to high SCD rates in MI patients, SCD risk should be assessed as early as during hospitalization, using relevant clinical and psychological parameters. If needed, detailed examination and secondary SCD prevention measures should be performed.https://cardiovascular.elpub.ru/jour/article/view/1482sudden deathmyocardial infarctionprognosisclinical and psychological factors
spellingShingle S. A. Boldueva
A. V. Shabrov
I. A. Leonova
T. Ya. Burak
M. V. Samokhvalova
O. V. Trofimova
E. G. Bykova
A. E. Gimgina
Clinical and psychological factors affecting sudden death risk in myocardial infarction patients
Кардиоваскулярная терапия и профилактика
sudden death
myocardial infarction
prognosis
clinical and psychological factors
title Clinical and psychological factors affecting sudden death risk in myocardial infarction patients
title_full Clinical and psychological factors affecting sudden death risk in myocardial infarction patients
title_fullStr Clinical and psychological factors affecting sudden death risk in myocardial infarction patients
title_full_unstemmed Clinical and psychological factors affecting sudden death risk in myocardial infarction patients
title_short Clinical and psychological factors affecting sudden death risk in myocardial infarction patients
title_sort clinical and psychological factors affecting sudden death risk in myocardial infarction patients
topic sudden death
myocardial infarction
prognosis
clinical and psychological factors
url https://cardiovascular.elpub.ru/jour/article/view/1482
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