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Published on: February 17, 2018

Syncope predicts the outcome of cardiomyopathy patients: analysis of the SCD-HeFT study

Brian Olshansky1, Jeanne E Poole, George Johnson

  • 1University of Iowa, Iowa City, Iowa, USA. brian-olshansky@uiowa.edu

Journal of the American College of Cardiology
|March 29, 2008
PubMed

Insights

Syncope in congestive heart failure patients predicts increased mortality risk, regardless of treatment. This finding highlights the importance of evaluating syncope in CHF patients for better outcomes.

Area of Science:

  • Cardiology
  • Clinical Electrophysiology
  • Heart Failure Management

Background:

  • The prognostic implications of syncope in congestive heart failure (CHF) patients remain incompletely understood.
  • The Sudden Cardiac Death Heart Failure Trial (SCD-HeFT) provides a valuable dataset for investigating syncope in this population.

Purpose of the Study:

  • To determine if syncope predicts adverse outcomes in patients with CHF.
  • To analyze the association between syncope and mortality in CHF patients within the SCD-HeFT trial.

Main Methods:

  • Analysis of data from the SCD-HeFT trial, comparing outcomes and clinical characteristics of patients with and without syncope.
  • Statistical analysis including hazard ratios (HR) and 95% confidence intervals (CI) to assess risk factors and outcomes.

Main Results:

  • Post-randomization syncope was associated with increased total and cardiovascular mortality (HR 1.41 and 1.55, respectively).
  • Syncope predicted appropriate implantable cardioverter-defibrillator (ICD) discharges in the ICD arm (HR 2.91).
  • The increased mortality risk associated with syncope did not significantly vary across treatment arms (ICD, amiodarone, placebo).

Conclusions:

  • Syncope is associated with an increased risk of mortality in CHF patients, irrespective of treatment with ICD, amiodarone, or placebo.
  • In CHF patients with ICDs, syncope correlates with appropriate ICD activations, suggesting its role as a marker for arrhythmic events.
Abstract

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