Sudden Cardiac Death in Heart Failure Patients With Preserved Ejection Fraction |
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| Authors: | Selcuk Adabag Lindsay G. Smith Inder S. Anand Alan K. Berger Russell V. Luepker |
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| Affiliation: | 1. Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota;2. Division of Cardiology, Veterans Affairs Medical Center, Minneapolis, Minnesota;1. Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California;2. Division of Nuclear Medicine and Molecular Imaging, Stanford University School of Medicine, Stanford, California;2. Surgery, Division of Cardiothoracic Surgery, Ohio State University, Wexner Medical Center, Columbus, OH;3. Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL;4. Department of Anesthesia and Critical Care, University of Chicago, Chicago, IL |
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| Abstract: | BackgroundWhereas sudden cardiac death (SCD) risk has been recognized in heart failure (HF) patients with reduced ejection fraction (HFrEF), less is known about SCD risk in HF patients with preserved EF (HFpEF). We examined the incidence and predictors of SCD in HFpEF in a large population sample.Methods and ResultsMedical records of patients discharged with a primary diagnosis of HF from hospitals in Minneapolis–St Paul in 1995 and 2000 were abstracted. HFpEF was defined as EF ≥45%. SCD was defined as cardiac arrest or out-of-hospital death due to coronary heart disease (CHD) on death certificates. A total of 2,203 patients (age 70 ± 11 years, 53% male) were included. The 787 patients (36%) with HFpEF were older, more often female and more likely to have hypertension than the 1,416 (64%) with HFrEF. All-cause mortality (52% vs 58%; P = .01) and SCD (6% vs 14%; P < .0001) rates were lower in HFpEF than in HFrEF 5 years after hospital discharge. Age, sex, CHD, and length of index hospitalization were the only independent predictors of SCD in HFpEF.ConclusionsIncidence of SCD in HFpEF is lower than in HFrEF. Present markers of SCD in HFpEF are sparse and insufficient to identify the patient at risk. |
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