Abstract 51: Long Term Survival after First Myocardial Infarction is not Determined by the Occurrence of Ventricular Fibrillation in the Acute Phase but Family History for Sudden Death is Detrimental
Introduction: A positive family history for sudden cardiac death is clearly associated with the development of ventricular fibrillation during a first myocardial infarction (primary VF). In our case-control study with 360 primary VF cases vs. 361 controls with first MI without VF we observed an OR of 3.28 (95% CI 1.95–5.49, p < 0.0001). We hypothesized that the hereditary susceptibility to primary VF also influences long-term survival.
Methods: Thorough follow-up data from our case-control study were obtained together with the family history for sudden cardiac death (defined as a first degree relative with unexplained sudden death < 80 yrs).
Results: Median follow-up was 4.5 years (range 0 to 23 years) for cases and 3.6 years (range 0 to 18.7 years) for controls (p = NS). Survival analysis showed equal survival > 30 days for patients with or without VF (p = NS) (figure⇓). Follow-up in primary VF patients with a positive family history for sudden cardiac death showed a trend towards poorer survival (p = 0.087).
Conclusion: Ventricular fibrillation in the setting of a first myocardial infarction does not influence survival > 30 days. A family history of sudden cardiac death may be associated with a poorer prognosis in primary ventricular fibrillation patients.