Familial sudden death is an important risk factor for primary ventricular fibrillation: a case-control study in acute...

Area of Science:

• Cardiology
• Clinical Medicine
• Medical Research

Background:

• Primary ventricular fibrillation (VF) is a leading cause of mortality during acute myocardial infarction (MI).
• Predicting which patients are at high risk for primary VF remains a significant clinical challenge.
• Early identification of at-risk individuals is critical for timely intervention and improved patient outcomes.

Purpose of the Study:

• To identify independent risk factors for primary VF in patients experiencing a first ST-elevation myocardial infarction (STEMI).
• To investigate the role of baseline characteristics, infarct properties, and family history in predicting primary VF.
• To enhance risk stratification models for sudden cardiac death in acute MI patients.

Main Methods:

• A case-control study design was employed, including 330 primary VF survivors (cases) and 372 controls with first STEMI.
• Patients with prior infarcts or structural heart disease were excluded to focus on primary VF risk.
• Electrocardiogram (ECG) parameters at admission, infarct characteristics, and family medical history were analyzed.

Main Results:

• No significant differences were observed in baseline characteristics, infarct size/location, culprit artery, or multivessel disease between cases and controls.
• Higher cumulative ST deviation on admission ECGs was significantly associated with primary VF (OR 1.59 per 10-mm ST deviation).
• Familial sudden death occurred significantly more frequently in cases (43.1%) compared to controls (25.1%; OR 2.72).

Conclusions:

• Cumulative ST deviation on admission ECG is a significant independent risk factor for primary VF in STEMI patients.
• A family history of sudden death is strongly associated with an increased risk of primary VF.
• These findings can improve risk stratification for primary VF in acute myocardial infarction.