Sudden Cardiac Death in Women With Suspected Ischemic Heart Disease, Preserved Ejection Fraction, and No Obstructive Coronary Artery Disease: A Report From the Women's Ischemia Syndrome Evaluation Study
BackgroundSudden cardiac death (SCD) is often the first presentation of ischemic heart disease; however, there is limited information on SCD among women with and without obstructive coronary artery disease (CAD). We evaluated SCD incidence in the WISE (Women's Ischemia Syndrome Evaluation) stud...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2017-08-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.117.005501 |
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| author | Puja K. Mehta B. Delia Johnson Tanya S. Kenkre Wafia Eteiba Barry Sharaf Carl J. Pepine Steven E. Reis William J. Rogers Sheryl F. Kelsey Diane V. Thompson Vera Bittner George Sopko Leslee J. Shaw C. Noel Bairey Merz |
| author_facet | Puja K. Mehta B. Delia Johnson Tanya S. Kenkre Wafia Eteiba Barry Sharaf Carl J. Pepine Steven E. Reis William J. Rogers Sheryl F. Kelsey Diane V. Thompson Vera Bittner George Sopko Leslee J. Shaw C. Noel Bairey Merz |
| author_sort | Puja K. Mehta |
| collection | DOAJ |
| description | BackgroundSudden cardiac death (SCD) is often the first presentation of ischemic heart disease; however, there is limited information on SCD among women with and without obstructive coronary artery disease (CAD). We evaluated SCD incidence in the WISE (Women's Ischemia Syndrome Evaluation) study. Methods and ResultsOverall, 904 women with suspected ischemic heart disease with preserved ejection fraction and core laboratory coronary angiography were followed for outcomes. In case of death, a death certificate and/or a physician or family narrative of the circumstances of death was obtained. A clinical events committee rated all deaths as cardiovascular or noncardiovascular and as SCD or non‐SCD. In total, 96 women (11%) died over a median of 6 years (maximum: 8 years). Among 65 cardiovascular deaths, 42% were SCD. Mortality per 1000 person‐hours increased linearly with CAD severity (no CAD: 5.8; minimal: 15.9; obstructive: 38.6; P<0.0001). However, the proportion of SCD was similar across CAD severity: 40%, 58%, and 38% for no, minimal, and obstructive CAD subgroups, respectively (P value not significant). In addition to traditional risk factors (age, diabetes mellitus, smoking), a history of depression (P=0.018) and longer corrected QT interval (P=0.023) were independent SCD predictors in the entire cohort. Corrected QT interval was an independent predictor of SCD in women without obstructive CAD (P=0.033). ConclusionsSCD contributes substantially to mortality in women with and without obstructive CAD. Corrected QT interval is the single independent SCD risk factor in women without obstructive CAD. In addition to management of traditional risk factors, these data indicate that further investigation should address mechanistic understanding and interventions targeting depression and corrected QT interval in women. |
| first_indexed | 2024-12-18T10:51:19Z |
| format | Article |
| id | doaj.art-d995eff839f74b91903c7c275700aef4 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-12-18T10:51:19Z |
| publishDate | 2017-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-d995eff839f74b91903c7c275700aef42022-12-21T21:10:27ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802017-08-016810.1161/JAHA.117.005501Sudden Cardiac Death in Women With Suspected Ischemic Heart Disease, Preserved Ejection Fraction, and No Obstructive Coronary Artery Disease: A Report From the Women's Ischemia Syndrome Evaluation StudyPuja K. Mehta0B. Delia Johnson1Tanya S. Kenkre2Wafia Eteiba3Barry Sharaf4Carl J. Pepine5Steven E. Reis6William J. Rogers7Sheryl F. Kelsey8Diane V. Thompson9Vera Bittner10George Sopko11Leslee J. Shaw12C. Noel Bairey Merz13Emory University School of Medicine, Atlanta, GAGraduate School of Public Health, University of Pittsburgh, PAGraduate School of Public Health, University of Pittsburgh, PAGraduate School of Public Health, University of Pittsburgh, PARhode Island Hospital, Providence, RIUniversity of Florida, Gainesville, FLUniversity of Pittsburgh Medical Center, Pittsburgh, PAUniversity of Alabama at Birmingham, ALGraduate School of Public Health, University of Pittsburgh, PAAllegheny General Hospital, Pittsburgh, PAUniversity of Alabama at Birmingham, ALAllegheny General Hospital, Pittsburgh, PAEmory University School of Medicine, Atlanta, GAEmory University School of Medicine, Atlanta, GABackgroundSudden cardiac death (SCD) is often the first presentation of ischemic heart disease; however, there is limited information on SCD among women with and without obstructive coronary artery disease (CAD). We evaluated SCD incidence in the WISE (Women's Ischemia Syndrome Evaluation) study. Methods and ResultsOverall, 904 women with suspected ischemic heart disease with preserved ejection fraction and core laboratory coronary angiography were followed for outcomes. In case of death, a death certificate and/or a physician or family narrative of the circumstances of death was obtained. A clinical events committee rated all deaths as cardiovascular or noncardiovascular and as SCD or non‐SCD. In total, 96 women (11%) died over a median of 6 years (maximum: 8 years). Among 65 cardiovascular deaths, 42% were SCD. Mortality per 1000 person‐hours increased linearly with CAD severity (no CAD: 5.8; minimal: 15.9; obstructive: 38.6; P<0.0001). However, the proportion of SCD was similar across CAD severity: 40%, 58%, and 38% for no, minimal, and obstructive CAD subgroups, respectively (P value not significant). In addition to traditional risk factors (age, diabetes mellitus, smoking), a history of depression (P=0.018) and longer corrected QT interval (P=0.023) were independent SCD predictors in the entire cohort. Corrected QT interval was an independent predictor of SCD in women without obstructive CAD (P=0.033). ConclusionsSCD contributes substantially to mortality in women with and without obstructive CAD. Corrected QT interval is the single independent SCD risk factor in women without obstructive CAD. In addition to management of traditional risk factors, these data indicate that further investigation should address mechanistic understanding and interventions targeting depression and corrected QT interval in women.https://www.ahajournals.org/doi/10.1161/JAHA.117.005501coronary atherosclerosisischemic heart diseasesudden cardiac deathwomen |
| spellingShingle | Puja K. Mehta B. Delia Johnson Tanya S. Kenkre Wafia Eteiba Barry Sharaf Carl J. Pepine Steven E. Reis William J. Rogers Sheryl F. Kelsey Diane V. Thompson Vera Bittner George Sopko Leslee J. Shaw C. Noel Bairey Merz Sudden Cardiac Death in Women With Suspected Ischemic Heart Disease, Preserved Ejection Fraction, and No Obstructive Coronary Artery Disease: A Report From the Women's Ischemia Syndrome Evaluation Study Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease coronary atherosclerosis ischemic heart disease sudden cardiac death women |
| title | Sudden Cardiac Death in Women With Suspected Ischemic Heart Disease, Preserved Ejection Fraction, and No Obstructive Coronary Artery Disease: A Report From the Women's Ischemia Syndrome Evaluation Study |
| title_full | Sudden Cardiac Death in Women With Suspected Ischemic Heart Disease, Preserved Ejection Fraction, and No Obstructive Coronary Artery Disease: A Report From the Women's Ischemia Syndrome Evaluation Study |
| title_fullStr | Sudden Cardiac Death in Women With Suspected Ischemic Heart Disease, Preserved Ejection Fraction, and No Obstructive Coronary Artery Disease: A Report From the Women's Ischemia Syndrome Evaluation Study |
| title_full_unstemmed | Sudden Cardiac Death in Women With Suspected Ischemic Heart Disease, Preserved Ejection Fraction, and No Obstructive Coronary Artery Disease: A Report From the Women's Ischemia Syndrome Evaluation Study |
| title_short | Sudden Cardiac Death in Women With Suspected Ischemic Heart Disease, Preserved Ejection Fraction, and No Obstructive Coronary Artery Disease: A Report From the Women's Ischemia Syndrome Evaluation Study |
| title_sort | sudden cardiac death in women with suspected ischemic heart disease preserved ejection fraction and no obstructive coronary artery disease a report from the women s ischemia syndrome evaluation study |
| topic | coronary atherosclerosis ischemic heart disease sudden cardiac death women |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.117.005501 |
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