Risk indicators for out-of-hospital cardiac arrest in patients with coronary artery disease
J J de Vreede-Swagemakers1, A P Gorgels, M P Weijenberg
1Department of Cardiology, University Hospital of Maastricht, The Netherlands.
Insights
Sudden cardiac arrest (SCA) risk factors in coronary artery disease (CAD) patients include prior myocardial infarction, hypertension, low ejection fraction, and heavy coffee intake. Moderate alcohol may offer protection.
Area of Science:
- Cardiology
- Public Health
Background:
- Coronary artery disease (CAD) is a leading cause of mortality worldwide.
- Sudden cardiac arrest (SCA) is a critical complication in patients with CAD.
- Identifying modifiable risk factors for SCA is crucial for improving patient outcomes.
Purpose of the Study:
- To investigate independent risk factors associated with SCA in patients diagnosed with coronary artery disease (CAD).
Main Methods:
- A retrospective case-control study design was employed.
- Patients with SCA and a history of CAD were compared to age- and gender-matched CAD control patients.
- Logistic regression analysis was used to assess the impact of various clinical and lifestyle factors.
Main Results:
- Previous myocardial infarction (MI), hypertension, left ventricular ejection fraction (LVEF) <40%, and heavy coffee consumption (>10 cups/day) were identified as significant independent risk factors for SCA.
- Conversely, moderate alcohol consumption (1-21 glasses/week) appeared to have a protective effect against SCA in this patient group.
Conclusions:
- Specific lifestyle modifications, such as reducing coffee intake and moderating alcohol consumption, may play a role in preventing SCA among CAD patients.
- Clinical factors like prior MI and reduced LVEF remain critical indicators for SCA risk stratification.
Abstract:
The objective of this study was to identify risk factors for sudden cardiac arrest (SCA) in patients with coronary artery disease (CAD). A retrospective case-control study was performed consisting of a group of unselected patients who had suffered SCA and had a clinical history of CAD, and a group of unselected age- and gender-matched CAD control patients living in the region of Maastricht. Information about previous myocardial infarction (MI), left ventricular ejection fraction (LVEF), hypertension, hypercholesterolemia, diabetes mellitus, smoking, and coffee and alcohol consumption was collected. A logistic regression model was fitted to all mentioned variables including age and genders. Included were 117 SCA cases (84% men, mean age 65 years [+/-7]) and 144 control patients (83% men, mean age 63 years [+/-8]). Previous MI (odds ratio [OR] 4.0, 95% confidence interval [CI] 1.7-9.3), hypertension (OR 2.9, 95% CI 1.5-6.1), heavy coffee consumption (>10 cups per day) (OR 55.7, 95% CI 6.4-483), and a LVEF <40% (OR 11.2, CI 4.4-28.5) were independent risk indicators for SCA in patients with CAD. Alcohol consumption (1-21 glasses per week) seemed to protect patients with CAD from SCA (OR 0.5, 95% CI 0.2-0.98). These observations suggest that changes in lifestyle factors can be of potential importance in protecting patients with CAD from dying suddenly.
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