Natural history of single vessel disease. Risk of sudden coronary death in relation to coronary anatomy and...

Area of Science:

• Cardiology
• Clinical Medicine
• Medical Research

Background:

• Single vessel disease affects a significant number of patients.
• Sudden cardiac death (SCD) remains a critical concern in cardiovascular disease.
• Predicting SCD risk in patients with specific coronary artery lesions is crucial.

Purpose of the Study:

• To investigate the incidence of sudden death in patients with single vessel disease.
• To identify risk factors associated with sudden death in this population.
• To correlate coronary artery lesions, left ventricular function, and arrhythmias with SCD.

Main Methods:

• Follow-up study of 214 patients with single vessel disease for 1-78 months.
• Ambulatory ECG monitoring to assess ventricular arrhythmias.
• Analysis of coronary artery lesions (LAD, RCA, LCX) and left ventricular wall motion.

Main Results:

• Overall incidence of sudden death was low in single vessel disease.
• Left anterior descending (LAD) and right coronary artery (RCA) lesions were associated with higher SCD rates (11% and 8%).
• Coronary artery occlusion significantly increased SCD risk compared to high-grade stenosis (15% vs 3%).
• Complex arrhythmias combined with LAD or RCA occlusion and akinetic left ventricular areas markedly elevated SCD risk (up to 21%).

Conclusions:

• Sudden death incidence is relatively low in patients with single vessel disease.
• Patients with LAD or RCA occlusion, particularly when associated with akinetic left ventricular areas and complex arrhythmias, face a high risk of sudden death.
• Risk stratification using ECG and ventricular function assessment is vital for managing patients with single vessel disease.