Utility of current risk stratification tests for predicting major arrhythmic events after myocardial infarction

Abstract

Sensitivities and specificities for the five tests were relatively similar. No one test was satisfactory alone for predicting risk. Combinations of tests in stages allowed us to stratify 91.8% of patients as either high-risk or low-risk. These data suggest that a large prospective study to develop a robust prediction model is feasible and desirable.

Predicting the Future

“…This would be analogous to the use of multiple positive results to enhance risk stratification for the identification of high-risk individuals. 34,35 …”

Risk Stratification for Sudden Cardiac Death

“…The utility of combining tests or performing risk stratification in a sequential manner has been demonstrated , 22,23 Based on the findings of the Risk Estimation Following Infarction, Noninvasive Evaluation (REFINE) study, 24 the REFINE-ICD trial is evaluating the efficacy of the ICD to reduce mortality in postinfarction patients with ejection fraction of 36% to 49% and abnormal T wave alternans and heart rate turbulence. The ideal combination of parameters, as well as time(s) for evaluation, need to be determined.…”

Implantable Cardioverter-Defibrillators in Sudden Cardiac Death Prevention: What Guidelines Don't Tell

“…Since the majority of SCDs occurs in the general population, the primary prevention goal is the identification of high-risk subsets. Numerous invasive and noninvasive techniques have been developed over the years to identify patients at risk for SCD [61][62][63]. Currently, assessment of left ventricular EF is commonly used to identify highrisk patients and to guide primary prevention of SCD [49].…”