Sudden Cardiac Death From the Perspective of Coronary Artery Disease

Abstract

Sudden cardiac death accounts for approximately 50% of all deaths attributed to cardiovascular disease in the United States. It is most commonly associated with coronary artery disease and can be its initial manifestation or may occur in the period after an acute myocardial infarction. Decreasing the rate of sudden cardiac death requires the identification and treatment of at-risk patients through evidence-based pharmacotherapy and interventional strategies aimed at primary and secondary prevention. For this review, we searched PubMed for potentially relevant articles published from January 1, 1970, through March 1, 2014, using the following key search terms: sudden cardiac death, ischemic heart disease, coronary artery disease, myocardial infarction, and cardiac arrest. Searches were enhanced by scanning bibliographies of identified articles, and those deemed relevant were selected for full-text review. This review outlines various mechanisms for sudden cardiac death in the setting of coronary artery disease, describes risk factors for sudden cardiac death, explores the management of cardiac arrest, and outlines optimal practice for the monitoring and treatment of patients after an acute ST-segment elevation myocardial infarction to decrease the risk of sudden death.

Factors associated with performing urgent coronary angiography in out‐of‐hospital cardiac arrest patients

“…Our study identified three main characteristics significantly associated with the decision to proceed with coronary angiography within six hours of presentation after OHCA: presentation with ST‐elevation on ECG, an initial shockable rhythm, and a history of coronary artery disease. Initial shockable rhythm and history of CAD are suggestive of a higher pre‐test probability of having an underlying acute coronary syndrome leading to cardiac arrest , and predicted a higher rate of UCA in our study. Prior studies have suggested that male gender, transfer from an outside hospital, presentation with ST‐elevation, and new left bundle branch block were associated with UCA whereas presence of an initial non‐shockable rhythm (pulseless electrical activity or asystole) and low GCS scores were inversely associated with UCA .…”

The Effect of Family-Centered Care on the Duration of Weaning From Mechanical Ventilation in Coronary Artery Bypass Surgery Patients: A Clinical Trial Study

“…Cardiovascular diseases in Iran, like many other countries, are the leading causes of death and the lost years of life (5). In addition, among the cardiovascular diseases, coronary artery diseases are introduced as the first and the most common cause of death (6).…”

The role of the sympathetic nervous system in sudden cardiac death

“…CAD is the most common cause of SCD in adults >40 years of age, with atherosclerotic CAD accounting for 75% to 80% of the cases in this cohort (19). It also needs to be emphasized that most of these SCD cases involve seemingly normal adults with no symptoms or history of CAD; therefore, some caution should be exercised for explaining the mechanisms of SCD in patients with CAD (20).…”