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Community
Study of Heart Attack Survivors finds risk
of sudden Cardiac Death highest early after
attack
Newswise — People who survive a heart attack
face the greatest risk of dying from sudden
cardiac death (SCD) during the first month
after leaving the hospital, according to a
long-term community study by Mayo Clinic
researchers of nearly 3,000 heart attack
survivors.
Sudden cardiac death can happen when the
heart’s electrical system malfunctions; if
treatment - cardiopulmonary resuscitation
and defibrillation - does not happen fast, a
person dies.
After that first month, the risk of sudden
cardiac death drops significantly - but
rises again if a person experiences signs of
heart failure. The research results appear
in the Nov. 5 edition of Journal of the
American Medical Association.
The Mayo Message
This study emphasizes the need for
physicians to stay in close contact with
their heart attack patients, forming a
partnership to recognize symptoms, says
Veronique Roger, M.D., M.P.H., a Mayo Clinic
cardiologist and lead author of the study.
Physicians and patients - and their family
members - need to be keenly alert for the
symptoms of heart failure, as described by
the American Heart Association, Dr. Roger
says.
Heart failure symptoms that require
immediate attention include:
* Shortness of breath
* Persistent cough or wheezing
* Bloating and swelling
* Fatigue
* Confusion
“There are three key findings here that can
be immediately applied to heart attack
patients today,” Dr. Roger says.
“One is that the first month post-heart
attack is the highest risk period for
patients to suffer sudden cardiac death -
and acute surveillance is warranted.
A second is that the risk drops rapidly
after the first month, but this does not
mean the patient is out of danger.
Surveillance is still required after the
first month because our third finding shows
that even though the risk drops after the
first month, the onset of symptoms of heart
failure at any time after the heart attack
markedly increases the risk of SCD.”
About the Study
The study is one of the largest and longest
comprehensive community studies performed by
reviewing medical records.
Drawing on data from the Rochester
Epidemiology Project, the study analyzed the
records of 2,997 men and women who had heart
attacks in Olmsted County, Minn. - the
county where Mayo Clinic is located -
between 1979 and 2005.
The patients’ average age was 67 years.
Patients were followed until death or the
last recorded medical exam.
Investigators were able to identify
out-of-hospital deaths whose primary cause
was listed as coronary heart disease.
This enabled them to analyze sudden cardiac
death trends. Housed at Mayo Clinic, the
Rochester Epidemiology Project is one of the
largest long-term, integrated databases of
patient records in the world.
Success of Secondary
Prevention
Another major finding of this study
identifies a long-term, positive trend in
the reduction of sudden deaths by nearly 40
percent over this time. This reflects
medical advances in the care of heart
patients, Dr. Roger says.
These include the use of rapid restoration
of blood flow during the initial phase of
the heart attack, treated by emergency care
and the adoption of “secondary prevention”
measures. These measures include diet and
lifestyle changes, such as taking
medications to lower cholesterol levels and
blood pressure. The measures help keep heart
disease from developing or progressing, Dr.
Roger says.
Collaboration and
Support
The Mayo Clinic research team also includes
Susan Weston; Bernard Gersh, M.B.Ch.B.,
D.Phil.; and Terry Therneau, Ph.D.
Collaborating in the research was A. Selcuk
Adabag, M.D., from the Veterans Affairs
Medical Center in Minneapolis. Their work
was funded by the U.S. Public Health
Service, the National Institutes of Health,
and the Veterans Affairs Clinical Science
Research & Development Service.
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