Syncope and risk of sudden cardiac arrest in coronary artery disease

Aapo L. Aro, Carmen Rusinaru, Audrey Uy-Evanado, Kyndaron Reinier, Derek Phan, Karen Gunson, Jonathan Jui, Sumeet S. Chugh

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background Syncope has been associated with increased risk of sudden cardiac arrest (SCA) in specific patient populations, such as hypertrophic cardiomyopathy, heart failure, and long QT syndrome, but data are lacking on the risk of SCA associated with syncope among patients with coronary artery disease (CAD), the most common cause of SCA. We investigated this association among CAD patients in the community. Methods All cases of SCA due to CAD were prospectively identified in Portland, Oregon (population approximately 1 million) as part of the Oregon Sudden Unexpected Death Study 2002–2015, and compared to geographical controls. Detailed clinical information including history of syncope and cardiac investigations was obtained from medical records. Results 2119 SCA cases (68.4 ± 13.8 years, 66.9% male) and 746 controls (66.7 ± 11.7 years, 67.0% male) were included in the analysis. 143 (6.8%) of cases had documented syncope prior to the SCA. SCA cases with syncope were > 5 years older and had more comorbidities than other SCA cases. After adjusting for clinical factors and left ventricular ejection fraction (LVEF), syncope was associated with increased risk of SCA (OR 2.8; 95%CI 1.68–4.85). When analysis was restricted to subjects with LVEF ≥ 50%, the risk of SCA associated with syncope remained significantly elevated (adjusted OR 3.1; 95%CI 1.68–5.79). Conclusions Syncope was associated with increased risk of SCA in CAD patients even with preserved LV function. These findings suggest a role for this clinical marker among patients with CAD and normal LVEF, a large sub-group without any current means of SCA risk stratification.

Original languageEnglish (US)
Pages (from-to)26-30
Number of pages5
JournalInternational Journal of Cardiology
Volume231
DOIs
StatePublished - Mar 15 2017

Fingerprint

Sudden Cardiac Death
Syncope
Coronary Artery Disease
Stroke Volume
Long QT Syndrome
Hypertrophic Cardiomyopathy
Sudden Death
Population
Medical Records
Comorbidity
Heart Failure
Biomarkers

Keywords

  • Coronary heart disease
  • Echocardiography
  • Left ventricular function
  • Oregon SUDS
  • Sudden cardiac death
  • Syncope

ASJC Scopus subject areas

  • Medicine(all)
  • Cardiology and Cardiovascular Medicine

Cite this

Aro, A. L., Rusinaru, C., Uy-Evanado, A., Reinier, K., Phan, D., Gunson, K., ... Chugh, S. S. (2017). Syncope and risk of sudden cardiac arrest in coronary artery disease. International Journal of Cardiology, 231, 26-30. https://doi.org/10.1016/j.ijcard.2016.12.021

Syncope and risk of sudden cardiac arrest in coronary artery disease. / Aro, Aapo L.; Rusinaru, Carmen; Uy-Evanado, Audrey; Reinier, Kyndaron; Phan, Derek; Gunson, Karen; Jui, Jonathan; Chugh, Sumeet S.

In: International Journal of Cardiology, Vol. 231, 15.03.2017, p. 26-30.

Research output: Contribution to journalArticle

Aro, AL, Rusinaru, C, Uy-Evanado, A, Reinier, K, Phan, D, Gunson, K, Jui, J & Chugh, SS 2017, 'Syncope and risk of sudden cardiac arrest in coronary artery disease', International Journal of Cardiology, vol. 231, pp. 26-30. https://doi.org/10.1016/j.ijcard.2016.12.021
Aro, Aapo L. ; Rusinaru, Carmen ; Uy-Evanado, Audrey ; Reinier, Kyndaron ; Phan, Derek ; Gunson, Karen ; Jui, Jonathan ; Chugh, Sumeet S. / Syncope and risk of sudden cardiac arrest in coronary artery disease. In: International Journal of Cardiology. 2017 ; Vol. 231. pp. 26-30.
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abstract = "Background Syncope has been associated with increased risk of sudden cardiac arrest (SCA) in specific patient populations, such as hypertrophic cardiomyopathy, heart failure, and long QT syndrome, but data are lacking on the risk of SCA associated with syncope among patients with coronary artery disease (CAD), the most common cause of SCA. We investigated this association among CAD patients in the community. Methods All cases of SCA due to CAD were prospectively identified in Portland, Oregon (population approximately 1 million) as part of the Oregon Sudden Unexpected Death Study 2002–2015, and compared to geographical controls. Detailed clinical information including history of syncope and cardiac investigations was obtained from medical records. Results 2119 SCA cases (68.4 ± 13.8 years, 66.9{\%} male) and 746 controls (66.7 ± 11.7 years, 67.0{\%} male) were included in the analysis. 143 (6.8{\%}) of cases had documented syncope prior to the SCA. SCA cases with syncope were > 5 years older and had more comorbidities than other SCA cases. After adjusting for clinical factors and left ventricular ejection fraction (LVEF), syncope was associated with increased risk of SCA (OR 2.8; 95{\%}CI 1.68–4.85). When analysis was restricted to subjects with LVEF ≥ 50{\%}, the risk of SCA associated with syncope remained significantly elevated (adjusted OR 3.1; 95{\%}CI 1.68–5.79). Conclusions Syncope was associated with increased risk of SCA in CAD patients even with preserved LV function. These findings suggest a role for this clinical marker among patients with CAD and normal LVEF, a large sub-group without any current means of SCA risk stratification.",
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AU - Aro, Aapo L.

AU - Rusinaru, Carmen

AU - Uy-Evanado, Audrey

AU - Reinier, Kyndaron

AU - Phan, Derek

AU - Gunson, Karen

AU - Jui, Jonathan

AU - Chugh, Sumeet S.

PY - 2017/3/15

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N2 - Background Syncope has been associated with increased risk of sudden cardiac arrest (SCA) in specific patient populations, such as hypertrophic cardiomyopathy, heart failure, and long QT syndrome, but data are lacking on the risk of SCA associated with syncope among patients with coronary artery disease (CAD), the most common cause of SCA. We investigated this association among CAD patients in the community. Methods All cases of SCA due to CAD were prospectively identified in Portland, Oregon (population approximately 1 million) as part of the Oregon Sudden Unexpected Death Study 2002–2015, and compared to geographical controls. Detailed clinical information including history of syncope and cardiac investigations was obtained from medical records. Results 2119 SCA cases (68.4 ± 13.8 years, 66.9% male) and 746 controls (66.7 ± 11.7 years, 67.0% male) were included in the analysis. 143 (6.8%) of cases had documented syncope prior to the SCA. SCA cases with syncope were > 5 years older and had more comorbidities than other SCA cases. After adjusting for clinical factors and left ventricular ejection fraction (LVEF), syncope was associated with increased risk of SCA (OR 2.8; 95%CI 1.68–4.85). When analysis was restricted to subjects with LVEF ≥ 50%, the risk of SCA associated with syncope remained significantly elevated (adjusted OR 3.1; 95%CI 1.68–5.79). Conclusions Syncope was associated with increased risk of SCA in CAD patients even with preserved LV function. These findings suggest a role for this clinical marker among patients with CAD and normal LVEF, a large sub-group without any current means of SCA risk stratification.

AB - Background Syncope has been associated with increased risk of sudden cardiac arrest (SCA) in specific patient populations, such as hypertrophic cardiomyopathy, heart failure, and long QT syndrome, but data are lacking on the risk of SCA associated with syncope among patients with coronary artery disease (CAD), the most common cause of SCA. We investigated this association among CAD patients in the community. Methods All cases of SCA due to CAD were prospectively identified in Portland, Oregon (population approximately 1 million) as part of the Oregon Sudden Unexpected Death Study 2002–2015, and compared to geographical controls. Detailed clinical information including history of syncope and cardiac investigations was obtained from medical records. Results 2119 SCA cases (68.4 ± 13.8 years, 66.9% male) and 746 controls (66.7 ± 11.7 years, 67.0% male) were included in the analysis. 143 (6.8%) of cases had documented syncope prior to the SCA. SCA cases with syncope were > 5 years older and had more comorbidities than other SCA cases. After adjusting for clinical factors and left ventricular ejection fraction (LVEF), syncope was associated with increased risk of SCA (OR 2.8; 95%CI 1.68–4.85). When analysis was restricted to subjects with LVEF ≥ 50%, the risk of SCA associated with syncope remained significantly elevated (adjusted OR 3.1; 95%CI 1.68–5.79). Conclusions Syncope was associated with increased risk of SCA in CAD patients even with preserved LV function. These findings suggest a role for this clinical marker among patients with CAD and normal LVEF, a large sub-group without any current means of SCA risk stratification.

KW - Coronary heart disease

KW - Echocardiography

KW - Left ventricular function

KW - Oregon SUDS

KW - Sudden cardiac death

KW - Syncope

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