Short- and long-term risk factors for sudden death in patients with stableangina

Sudden death is most common and often the first manifestation of coronary h eart disease although its risk is difficult to predict. It has been studied mainly in patients with severe ventricular arrhythmia or recent myocardial infarction, but little is known about the different risk factors for short - and long-term risk of sudden death in patients with stable angina. To ass ess risk factors for sudden death in patients with stable angina and angiog raphically proven coronary artery disease, 319 consecutive patients were re cruited prospectively and followed-up. Patients with clinical heart failure or recent myocardial infarction were excluded. Clinical, angiographic and biological variables were recorded. The association between each variable a nd the risk of sudden death was assessed in univariate and logistic multiva riate analysis. There were 25 sudden deaths during the follow-up period (97 +/-29 months). The univariate predictors in the short-term (2 years) were: peripheral arterial disease, left ventricular hypertrophy, low density lipo protein cholesterol and ejection fraction. The independent predictors were: peripheral arterial disease (relative risk: 6.3), ejection fraction (relat ive risk 1.05) and low density lipoprotein (relative risk: 1.8). In the lon g-term (8-10 years), body mass index, coronary score, ejection fraction and fibrinogen were univariate predictors. Only body mass index (relative risk : 1.2), ejection fraction (relative risk: 1.06) and fibrinogen (relative ri sk: 2) remained independent predictors. The risk factors for sudden death i n stable angina were time-dependent, peripheral arterial disease appeared a s the best predictor with LDL for short time, and body mass index (obesity: index >27) and fibrinogen for long time. Ejection fraction was the only ti me-independent predictor. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.