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Sudden Death in Patients with Myocardial Infarction and Left Ventricular Dysfunction, Heart Failure, or Both

Solomon, Scott D., Zelenkofske, Steve, McMurray, John J.V., Finn, Peter V., Velazquez, Eric, Ertl, George, Harsanyi, Adam, Rouleau, Jean L., Maggioni, Aldo, Kober, Lars, White, Harvey, Van de Werf, Frans, Pieper, Karen, Califf, Robert M., Pfeffer, Marc A.·2005·New England Journal of Medicine

Abstract

BACKGROUND: The risk of sudden death from cardiac causes is increased among survivors of acute myocardial infarction with reduced left ventricular systolic function. We assessed the risk and time course of sudden death in high-risk patients after myocardial infarction. METHODS: We studied 14,609 patients with left ventricular dysfunction, heart failure, or both after myocardial infarction to assess the incidence and timing of sudden unexpected death or cardiac arrest with resuscitation in relation to the left ventricular ejection fraction. RESULTS: Of 14,609 patients, 1067 (7 percent) had an event a median of 180 days after myocardial infarction: 903 died suddenly, and 164 were resuscitated after cardiac arrest. The risk was highest in the first 30 days after myocardial infarction--1.4 percent per month (95 percent confidence interval, 1.2 to 1.6 percent)--and decreased to 0.14 percent per month (95 percent confidence interval, 0.11 to 0.18 percent) after 2 years. Patients with a left ventricular ejection fraction of 30 percent or less were at highest risk in this early period (rate, 2.3 percent per month; 95 percent confidence interval, 1.8 to 2.8 percent). Nineteen percent of all sudden deaths or episodes of cardiac arrest with resuscitation occurred within the first 30 days after myocardial infarction, and 83 percent of all patients who died suddenly did so in the first 30 days after hospital discharge. Each decrease of 5 percentage points in the left ventricular ejection fraction was associated with a 21 percent adjusted increase in the risk of sudden death or cardiac arrest with resuscitation in the first 30 days. CONCLUSIONS: The risk of sudden death is highest in the first 30 days after myocardial infarction among patients with left ventricular dysfunction, heart failure, or both. Thus, earlier implementation of strategies for preventing sudden death may be warranted in selected patients.

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Metadata

Authors
Solomon, S. D., Zelenkofske, S., McMurray, J. J. V., Finn, P. V., Velazquez, E., Ertl, G., Harsanyi, A., Rouleau, J. L., Maggioni, A., Kober, L., White, H., Van de Werf, F., Pieper, K., Califf, R. M., & Pfeffer, M. A.
Venue
New England Journal of Medicine
Published
2005-06-23
Volume
352
Issue
25
Pages
2581-2588
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
OpenAlex
W2031769460
Cited by
793
References
5
FWCI
28.43
Type
journal article
Language
en
Open access
closed

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CoChat. (2026). Citation check: Sudden Death in Patients with Myocardial Infarction and Left Ventricular Dysfunction, Heart Failure, or Both. https://app.cochat.ai/papers/10.1056/nejmoa043938
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Solomon, S. D., Zelenkofske, S., McMurray, J. J. V., Finn, P. V., Velazquez, E., Ertl, G., Harsanyi, A., Rouleau, J. L., Maggioni, A., Kober, L., White, H., Van de Werf, F., Pieper, K., Califf, R. M., & Pfeffer, M. A. (2005). Sudden Death in Patients with Myocardial Infarction and Left Ventricular Dysfunction, Heart Failure, or Both. New England Journal of Medicine. https://doi.org/10.1056/nejmoa043938

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

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