In-hospital sudden cardiac death and ST-segment elevation myocardial infarction: Results from RESCUE

• Main Author: Miguel A. Rodríguez Ramos
• Format: Article
• Language: English
• Published: Cardiocentro Ernesto Che Guevara 2017-10-01
• Series: CorSalud
• Online Access: http://www.revcorsalud.sld.cu/index.php/cors/article/view/269

Introduction: The sudden cardiovascular death (SCD) is one of the main challenges of modern cardiology. After a ST-segment elevation myocardial infarction (STEMI), the characteristics of the vulnerable myocardium can lead to the final arrhythmia in the in-hospital stage of the treatment of these patients. Objective: To identify the association between parameters at admission of patients with STEMI and the emergence of the in-hospital SCD. Method: A retrospective analysis of 251 consecutive patients from the registry of acute coronary syndromes (RESCUE, by its acronym in Spanish) was performed, who were admitted with STEMI between June 2014 and February 2016. The SCD was defined as secondary to cardiac rupture, malignant ventricular arrhythmias or acute heart failure. Two groups were established according to the presence or absence of SCD and morphometric characteristics, health history, performance times of patients and system, and clinical findings were collected. Results: Patients with SCD were older (76.6±7.72 vs. 65.1±14.2 years, p=0.001), they came later to the doctor (469.4±295.8 vs. 344.1±262.1 minutes), they had a lower frequency of reperfusion (0 vs. 22%, p=0.02) and a higher score on the GRACE scale (129.2±12.58 vs. 101±27.07, p=0.001). Women presented worse prognosis (55% vs. 30.3% p=0.023), although this difference may be due to older age in that subgroup (78.45±7.92 vs. 70.23±11.98; p=0.031). The history of smoking was paradoxically related to the SCD (30% vs. 55.84%, p=0.028). Conclusions: The SCD was associated with characteristics that can be determined at the admission of patients with STEMI.