Abstract 2015: Sudden Cardiac Death in Patients with Diastolic Heart Failure
Background: Although it has been suggested that patients with diastolic heart failure are at an increased risk for sudden cardiac death (SCD), to date, the risk of SCD in such patients has not been clearly characterized. We conducted this study to examine the incidence and predictors of SCD in patients with diastolic heart failure.
Methods: We used the Duke Cardiovascular Database that has systematically collected the in-hospital clinical experience and the long term follow-up of all cardiology patients who undergo a cardiac catheterization at our institution. We identified patients with a history of CHF and an ejection fraction of greater than 50% who were enrolled in the Database from 1995 through 2004. Mode of death was adjudicated by two independent reviewers. We compared the baseline characteristics of patients who died suddenly with those who died of other causes. Using a Cox proportional hazards model, we determined predictors of SCD.
Results: Of the 2,314 patients who met the inclusion criteria, 661 (29%) died. Compared with patients who died of other causes (616; 93%), those who died suddenly (45; 7%) were more likely to be men (p 0.01) and to have had a history of an MI (p 0.05), peripheral vascular disease (p 0.04) and hyperlipidemia (p 0.04). Patients who died suddenly had a larger body mass index (p 0.05) and more diseased coronary arteries (p 0.008). Significant independent predictors of SCD are shown in the table⇓.
Conclusions: We identified predictors of SCD in patients with diastolic heart failure. Whether therapies directed at reducing the risk of SCD would reduce the risk of death in such patients needs to be explored by future studies.