Sudden Cardiac Death in Heart Failure: A 20-Year Perspective From a Mediterranean Cohort

• Published in: Journal of cardiac failure Vol. 29; no. 3; pp. 236 - 245
• Main Authors: Codina, PAU, ZAMORA, ELISABET, LEVY, WAYNE C, CEDIEL, GERMÁN, SANTIAGO-VACAS, EVELYN, DOMINGO, MAR, RUIZ-CUETO, MARÍA, CASQUETE, DANIEL, SARRIAS, AXEL, BORRELLAS, ANDREA, SANTESMASES, JAVIER, ESPRIELLA, RAFAEL DE LA, NUÑEZ, JULIO, AIMO, ALBERTO, LUPÓN, JOSEP, BAYES-GENIS, ANTONI
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.03.2023
• Subjects: Death, Sudden, Cardiac - epidemiology; Death, Sudden, Cardiac - etiology; Defibrillators, Implantable - adverse effects; Heart Failure; Humans; Mediterranean basin; Risk Factors; risk model; Stroke Volume; Sudden cardiac death; Ventricular Function, Left; Sudden cardiac death; Mediterranean basin; risk model
• ISSN: 1071-9164; 1532-8414
• DOI: 10.1016/j.cardfail.2022.11.016

•The proportion of SCD was significantly lower than expected based on the SPRM score.•The results were independent of the degree of predicted risk, ischemic etiology, the period of admission, and the presence of an implanted ICD.•The characteristics of our cohort might play a role in this lower than expected proportional risk of SCD. The prediction of sudden cardiac death (SCD) in heart failure (HF) remains an unmet need. The aim of our study was to assess the prevalence of SCD over 20 years in outpatients with HF managed in a Mediterranean multidisciplinary HF Clinic, and to compare the proportion of SCD (SCD/all-cause death) to the expected proportional occurrence based on the validated Seattle Proportional Risk Model (SPRM) score. This prospective observational registry study included 2772 outpatients with HF admitted between August 2001 and May 2021. Patients were included when the cause of death was known and SPRM score was available. Over the 20-year study period, 1351 patients (48.7%) died during a median follow-up period of 3.8 years (interquartile range 1.6–7.6). Among these patients, the proportion of SCD out of the total of deaths was 13.6%, whereas the predicted by SPRM was 39.6%. This lower proportion of SCD was observed independently of left ventricular ejection fraction, ischemic etiology, and the presence of an implantable cardiac defibrillator. In a Mediterranean cohort of outpatients with HF, the proportion of SCD was lower than expected based on the SPRM score. Future studies should investigate to what extend epidemiological and guideline-directed medical therapy patterns influence SCD. [Display omitted]