title: Sudden cardiac death and left ventricular ejection fraction during long-term follow-up after acute myocardial infarction in the primary percutaneous coronary intervention era: results from the HIJAMI-II registry.
abstract: OBJECTIVE
  To determine the incidence of sudden cardiac death (SCD) according to left ventricular ejection fraction (LVEF) in survivors of myocardial infarction (MI) in the primary percutaneous coronary intervention (PCI) era.
  
  
  METHODS
  A multicentre observational prospective registered cohort study.
  
  
  METHODS
  18 medical centres in Japan.
  
  
  METHODS
  4122 consecutive patients (mean age 66 (SD 12) years, 73.7% male) with acute MI, who were discharged alive.
  
  
  METHODS
  The primary end-point was SCD, and a secondary end-point was death from any cause.
  
  
  RESULTS
  Patients were categorised into three groups: LVEF >40% (n = 3416), LVEF < or =40% and >30% (n = 507) and LVEF < or =30% (n = 199). Among all patients, 77.8% received PCI and 3.7% received coronary artery bypass graft surgery. During an average follow-up of 4.1 years, SCD was 1.2% and mortality was 13.1%. Patients with LVEF < or =30% and LVEF < or =40% and >30% were at increased risk for SCD (HR 5.99, 95% CI 2.73 to 13.14, p<0.001, HR 3.37, 95% CI 1.74 to 6.50, p<0.001, respectively), and mortality (HR 3.85, 95% CI 2.96 to 5.00, p<0.001, HR 2.06, 95% CI 1.66 to 2.57, p<0.001, respectively), compared to patients with LVEF >40%. Kaplan-Meier estimates of SCD in patients with LVEF < or =30% were 2.9%, 5.1% and 5.1% at 1, 3 and 5 years, respectively.
  
  
  CONCLUSIONS
  There is a low incidence of SCD in survivors of MI in the primary PCI era, although LVEF is a predictor of increased risk for SCD.
authors: Department of Cardiology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan. mshiga@hij.twmu.ac.jp
authors: T
authors: T
authors: Shiga
authors: N
authors: N
authors: Hagiwara
authors: H
authors: H
authors: Ogawa
authors: A
authors: A
authors: Takagi
authors: M
authors: M
authors: Nagashima
authors: T
authors: T
authors: Yamauchi
authors: Y
authors: Y
authors: Tsurumi
authors: R
authors: R
authors: Koyanagi
authors: H
authors: H
authors: Kasanuki
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000379:methods / Q000401:mortality*; D016757:Death, Sudden, Cardiac / Q000453:epidemiology / Q000517:prevention & control*; D017147:Defibrillators, Implantable; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D009203:Myocardial Infarction / Q000401:mortality* / Q000628:therapy; D011446:Prospective Studies; D013318:Stroke Volume / Q000502:physiology*; D016019:Survival Analysis; D017741:Survivors; D016896:Treatment Outcome