Preventing tomorrow's sudden cardiac death today: part I: Current data on risk stratification for sudden cardiac death.
Accurate and timely prediction of sudden cardiac death (SCD) is a necessary prerequisite for effective prevention and therapy. Although the largest number of SCD events occurs in patients without overt heart disease, there are currently no tests that are of proven predictive value in this population. Efforts in risk stratification for SCD have focused primarily on predicting SCD in patients with known structural heart disease. Despite the ubiquity of tests that have been purported to predict SCD vulnerability in such patients, there is little consensus on which test, in addition to the left ventricular ejection fraction, should be used to determine which patients will benefit from an implantable cardioverter defibrillator. On July 20 and 21, 2006, a group of experts representing clinical cardiology, cardiac electrophysiology, biostatistics, economics, and health policy were joined by representatives of the US Food and Drug administration, Centers for Medicare Services, Agency for Health Research and Quality, the Heart Rhythm Society, and the device and pharmaceutical industry for a round table meeting to review current data on strategies of risk stratification for SCD, to explore methods to translate these strategies into practice and policy, and to identify areas that need to be addressed by future research studies. The meeting was organized by the Duke Center for the Prevention of SCD at the Duke Clinical Research Institute and was funded by industry participants. This article summarizes the presentations and discussions that occurred at that meeting.
Al-Khatib
Sana M
SM
The Duke Clinical Research Institute, Durham, NC 27715, USA. alkha001@mc.duke.edu
Sanders
Gillian D
GD
Bigger
J Thomas
JT
Buxton
Alfred E
AE
Califf
Robert M
RM
Carlson
Mark
M
Curtis
Anne
A
Curtis
Jeptha
J
Fain
Eric
E
Gersh
Bernard J
BJ
Gold
Michael R
MR
Haghighi-Mood
Ali
A
Hammill
Stephen C
SC
Healey
Jeff
J
Hlatky
Mark
M
Hohnloser
Stefan
S
Kim
Raymond J
RJ
Lee
Kerry
K
Mark
Daniel
D
Mianulli
Marcus
M
Mitchell
Brent
B
Prystowsky
Eric N
EN
Smith
Joseph
J
Steinhaus
David
D
Zareba
Wojciech
W
D001145:Arrhythmias, Cardiac / Q000453:epidemiology; D017704:Baroreflex; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000145:classification / Q000175:diagnosis* / Q000401:mortality* / Q000628:therapy; D015897:Comorbidity; D016757:Death, Sudden, Cardiac / Q000453:epidemiology / Q000517:prevention & control*; D004562:Electrocardiography; D005500:Follow-Up Studies; D005820:Genetic Testing; D006801:Humans; D011237:Predictive Value of Tests; D012042:Registries; D018570:Risk Assessment / Q000379:methods*; D012680:Sensitivity and Specificity; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000453:epidemiology
D015415:Biomarkers