Risk indicators for out-of-hospital cardiac arrest in patients with coronary artery disease

The objective of this study was to identify risk factors for sudden cardiac arrest (SCA) in patients with coronary artery disease (CAD). A retrospecti ve case-control study was performed consisting of a group of unselected pat ients who had suffered SCA and had a clinical history of CAD, and a group o f unselected age- and gender-matched CAD control patients living in the reg ion of Maastricht. Information about previous myocardial infarction (MI), l eft ventricular ejection fraction (LVEF), hypertension, hypercholesterolemi a, diabetes mellitus, smoking, and coffee and alcohol consumption was colle cted. A logistic regression model was fitted to all mentioned variables inc luding age and genders. Included were 117 SCA cases (84% men, mean age 65 y ears [+/- 7]) and 144 control patients (83% men, mean age 63 years [+/-8]). Previous MI (odds ratio [OR] 4.0, 95% confidence interval [CI] 1.7-93), hy pertension (OR 2.9, 95% CI 1.5-6.1), heavy coffee consumption (>10 cups per day) (OR 55.7, 95% CI 6.4-483), and a LVEF < 40% (OR 11.2, CI 4.4-28.5) we re independent risk indicators for SCA in patients with CAD. Alcohol consum ption (1-21 glasses per week) seemed to protect patients with CAD from SCA (OR 0.5, 95% CI 0.2-0.98). These observations suggest that changes in lifes tyle factors can be of potential importance in protecting patients with CAD from dying suddenly. (C) 1999 Elsevier Science Inc.