Sudden cardiac death in patients with myocardial infarction: 1.5 primary prevention

Abstract

Sudden cardiac death (SCD) is one of the most common causes of death in the world. Coronary heart disease (CHD) is the root cause of most patients with SCD, and myocardial infarction (MI) is the main cause of SCD among all types of CHD. Early identification of high-risk patients after an MI, and the application of related prevention strategies and disease-specific treatments will be the key to reduce SCD. The mechanism of SCD after MI varies over time, and the relevant risk prediction indicators are also dynamic and different. In the existing guidelines for MI patients, the static and slightly single stratification of primary (PP) and secondary (SP) prevention has significant room for improvement. The 1.5 primary prevention (1.5PP) is defined as patients with PP who also had the following risk factors: non-sustained ventricular tachycardia (NSVT), frequent premature ventricular contractions (PVCs), severe heart failure (left ventricular ejection fraction, LVEF <25%), and syncope or pre-syncope. The emergence of 1.5PP has provided a new method for the stratification and management of SCD after an MI.

Diagnostic value of cardiac miR-126-5p, miR-134-5p, and miR-499a-5p in coronary artery disease-induced sudden cardiac death

“…In this study, besides death being completely responsible for fatal CAD while other causes of death were excluded by postmortem investigation, CAD-SCD was diagnosed if at least one of the following signs was found: ( 1 ) unstable plaque (plaque rupture, thick fibrous cap, angiogenesis, etc. ); ( 2 ) coronary embolism; ( 3 ) contraction band necrosis; ( 4 ) myocardial hemorrhage; ( 5 ) acute inflammatory cells infiltration; and ( 6 ) sudden cardiac symptoms within 1 h before death clarified by a witness.…”

“…Individuals who met any of the following conditions were excluded: ( 1 ) age < 18; ( 2 ) intoxication caused by any poison or drug; ( 3 ) signs of asphyxia; and ( 4 ) a history of cardiac surgery.…”

“…It contributes to a considerable number of unexpected natural deaths worldwide, especially for the young and middle-aged people ( 1 ). Coronary artery disease (CAD) is the leading cause of SCD, and CAD-induced SCD (CAD-SCD) is responsible for ~80% of unexpected cardiac deaths ( 2 ).…”

Plasma extracellular vesicles microRNA-208b-3p and microRNA-143-3p as novel biomarkers for sudden cardiac death prediction in acute coronary syndrome

“…4 Eighty percent of SCD cases are caused by coronary heart disease (CHD) and its complications, while the rest are caused by cardiomyopathy, heart valve disease, congenital heart disease, pulmonary embolism, etc. 5 Acute coronary syndrome (ACS) is the most serious subset of CHD and is life-threatening, affecting over a million people per year. 6 ACS occurs as a result of myocardial ischemia and includes ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation myocardial infarction (NSTEMI) and unstable angina (UA).…”

From evidence-based medicine to digital twin technology for predicting ventricular tachycardia in ischaemic cardiomyopathy

“…Further, an introduction to data-driven models and mechanistic models are given, including some state-of-the-art examples for VT and VT-ablation prediction ( § §3 and 4, respectively). Not all studies will be discussed in detail, since there is an abundance of excellent clinical reviews [13,14], cardiac AI reviews [15][16][17][18][19] and cardiac mechanistic model reviews [20][21][22][23] available. The second objective builds on the insights obtained by the exploration of the existing literature and aims to provide our perspective on the open challenges and gains of Approach 4, the digital twin concept, and how it is envisioned to move VT prediction from population based to a patient-specific approach ( §5).…”