Avoiding Sudden Cardiac Death

Postmenopausal women with coronary artery disease at increased sudden cardiac death risk

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) At one time sudden cardiac death was viewed as rather random, but now new risk factors are regularly identified. One group that is at a higher risk is postmenopausal women with coronary artery disease.

Until recently, little research had indicated that postmenopausal women with heart disease would be at an increased risk for sudden cardiac death.

"Consider a screening if you have several risk factors for sudden cardiac death."

Dr. Rajat Deo, study lead author and an assistant professor of medicine in the Perelman School of Medicine's cardiovascular division, said the research revealed an important subset of women at increased risk of sudden cardiac death. He said an identified series of clinical risk factors could eventually aid doctors in better advising women on the best ways to avoid sudden cardiac death through steps such as increasing exercise and controlling diabetes.

About 250,000 people die from sudden cardiac death each year. Most die within an hour of the onset of symptoms. It can be difficult to predict who may be at risk because many cases occur among individuals without advanced heart disease.

Investigators from the Perelman School of Medicine and University of California San Francisco analyzed data from the Heart and Estrogen/Progestin Replacement Study (HERS). That research was undertaken to evaluate the effects of hormone replacement therapy on cardiovascular events among 2,763 postmenopausal women with coronary artery disease.

Dr. Deo's research revealed that sudden cardiac death resulted in 54 percent of heart-related deaths in those patients, or about a quarter of all deaths during the study. Dr. Deo called the large amount remarkable, and higher than expected. He said that under current methods for identifying those at risk of sudden cardiac death, most would not have been considered high risk.

The only established predictor for sudden cardiac death is evaluation of the heart's pumping capacity in the left ventricle through ejection fraction measurement. The test can accurately measure the percentage of blood that is pumped out of the left ventricle with each heartbeat. Recent research suggests about a third of those who experience sudden cardiac death could have been identified with this clinical test.

Researchers also pinpointed characteristics that could increase risk for sudden cardiac death. Those at an added risk were those with previous heart attack, heart failure, atrial fibrillation, physical inactivity, diabetes, and reduced kidney function. Women with at least three of the risk factors were at a ten-fold greater risk than women with none of the risk factors.

The research was published in the Archives of Internal Medicine.

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Review Date: 
August 1, 2011
Last Updated:
August 4, 2011