title: Potential of non-antiarrhythmic drugs to provide an innovative upstream approach to the pharmacological prevention of sudden cardiac death.
abstract: Sudden cardiac death (SCD) is the most common cause of death and often occurs in low-risk patients. Present prevention strategies, mainly confined to high-risk subjects (proposed implantable cardioverter defibrillators recipients), have a limited effect on SCD burden in the general population. A relatively unexplored strategy for extending SCD prevention could imply targeting the early (upstream) processes of the complex cascade leading to SCD by non-antiarrhythmic drugs (i.e., beta-blockers, aldosterone antagonists, angiotensin-converting enzyme inhibitors, angiotensin receptor-blocker agents, statins and omega-3 fatty acids). In this innovative pharmacological perspective, agents with upstream effects may also be used in high-risk patients in association with a strictly downstream intervention, such as the implantable cardioverter defibrillator, in an attempt to obtain an additive/synergetic effect.
authors.affiliation: University of Bologna, Institute of Cardiology, Policlinico S Orsola-Malpighi, via Massarenti n.9, 40138 Bologna, Italy. giuseppe.boriani@unibo.it
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Boriani
authors.forename: Cinzia
authors.initials: C
authors.lastname: Valzania
authors.forename: Igor
authors.initials: I
authors.lastname: Diemberger
authors.forename: Mauro
authors.initials: M
authors.lastname: Biffi
authors.forename: Cristian
authors.initials: C
authors.lastname: Martignani
authors.forename: Matteo
authors.initials: M
authors.lastname: Bertini
authors.forename: Matteo
authors.initials: M
authors.lastname: Ziacchi
authors.forename: Giulia
authors.initials: G
authors.lastname: Domenichini
authors.forename: Davide
authors.initials: D
authors.lastname: Saporito
authors.forename: Claudio
authors.initials: C
authors.lastname: Rapezzi
authors.forename: Angelo
authors.initials: A
authors.lastname: Branzi
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D016757:Death, Sudden, Cardiac / Q000209:etiology / Q000517:prevention & control*; D017147:Defibrillators, Implantable; D015525:Fatty Acids, Omega-3 / Q000627:therapeutic use; D006331:Heart Diseases / Q000150:complications / Q000188:drug therapy* / Q000628:therapy; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use
chemical_list: D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D002317:Cardiovascular Agents; D015525:Fatty Acids, Omega-3; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000451:Mineralocorticoid Receptor Antagonists