Familial sudden death is an important risk factor for primary ventricular fibrillation: a case-control study in acute myocardial infarction patients.
BACKGROUND
Primary ventricular fibrillation (VF) accounts for the majority of deaths during the acute phase of myocardial infarction. Identification of patients at risk for primary VF remains very poor.


RESULTS
We performed a case-control study in patients with a first ST-elevation myocardial infarction (STEMI) to identify independent risk factors for primary VF. A total of 330 primary VF survivors (cases) and 372 controls were included; patients with earlier infarcts or signs of structural heart disease were excluded. Baseline characteristics, including age, gender, drug use, and ECG parameters registered well before the index infarction, as well as medical history, were not different. Infarct size and location, culprit coronary artery, and presence of multivessel disease were similar between groups. Analysis of ECGs performed at hospital admission for the index STEMI revealed that cumulative ST deviation was significantly higher among cases (OR per 10-mm ST deviation 1.59, 95% CI 1.25 to 2.02). Analysis of medical histories among parents and siblings showed that the prevalence of cardiovascular disease was similar between cases and controls (73.1% and 73.0%, respectively); however, familial sudden death occurred significantly more frequently among cases than controls (43.1% and 25.1%, respectively; OR 2.72, 95% CI 1.84 to 4.03).


CONCLUSIONS
In a population of STEMI patients, the risk of primary VF is determined by cumulative ST deviation and family history of sudden death.
Dekker
Lukas R C
LR
Department of Cardiology, B2-116, Academic Medical Center, PO Box 22660, 1100 DD, Amsterdam, The Netherlands. L.R.Dekker@amc.uva.nl
Bezzina
Connie R
CR
Henriques
José P S
JP
Tanck
Michael W
MW
Koch
Karel T
KT
Alings
Marco W
MW
Arnold
Alfred E R
AE
de Boer
Menko-Jan
MJ
Gorgels
Anton P M
AP
Michels
H Rolf
HR
Verkerk
Agnes
A
Verheugt
Freek W A
FW
Zijlstra
Felix
F
Wilde
Arthur A M
AA
D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000150:complications / Q000503:physiopathology; D016022:Case-Control Studies; D016757:Death, Sudden, Cardiac / Q000209:etiology* / Q000473:pathology / Q000517:prevention & control; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000235:genetics* / Q000473:pathology; D009426:Netherlands; D010641:Phenotype; D018570:Risk Assessment; D012307:Risk Factors; D015996:Survival Rate; D014693:Ventricular Fibrillation / Q000150:complications* / Q000401:mortality / Q000503:physiopathology*