期刊
JOURNAL OF THE AMERICAN HEART ASSOCIATION
卷 6, 期 8, 页码 -出版社
WILEY
DOI: 10.1161/JAHA.117.005501
关键词
coronary atherosclerosis; ischemic heart disease; sudden cardiac death; women
资金
- National Heart, Lung, and Blood Institute's [N01-HV-68161, N01-HV-68162, N01-HV-68163, N01-HV-68164, U0164829, U01 HL649141, U01 HL649241, K23HL 105787, T32HL69751, R01 HL090957, 1R03AG032631]
- National Institute on Aging
- General Clinical Research Center [MO1-RR00425]
- National Center for Research Resources
- National Center for Advancing Translational Sciences [UL1TR000124]
- Gustavus and Louis Pfeiffer Research Foundation, Danville, NJ
- Women's Guild of Cedars-Sinai Medical Center, Los Angeles, CA
- Ladies Hospital Aid Society of Western Pennsylvania, Pittsburgh, PA
- Qmed Inc., Laurence Harbor, NJ
- Constance Austin Women's Heart Research Fellowship
- Barbra Streisand Women's Cardiovascular Research and Education Program
- Cedars-Sinai Medical Center, Los Angeles
- Society for Women's Health Research (SWHR), Washington, DC
- Linda Joy Pollin Women's Heart Health Program
- Erika Glazer Women's Heart Health Project
- Adelson Family Foundation
- Cedars-Sinai Medical Center, Los Angeles, California
- National Institutes of Health [HL33610, HL56921, UM1 HL087366]
- Gatorade Trust
- NIH NCATS-University of Florida Clinical and Translational Science [UL1TR001427]
- PCORnet-OneFlorida Clinical Research Consortium Clinical Data Research Network [1501-26692]
- Edythe L. Broad Constance Austin Women's Heart Research Fellowship
Background-Sudden cardiac death (SCD) is often the first presentation of ischemic heart disease; however, there is limited information on SCD among women with and without obstructive coronary artery disease (CAD). We evaluated SCD incidence in the WISE (Women's Ischemia Syndrome Evaluation) study. Methods and Results-Overall, 904 women with suspected ischemic heart disease with preserved ejection fraction and core laboratory coronary angiography were followed for outcomes. In case of death, a death certificate and/or a physician or family narrative of the circumstances of death was obtained. A clinical events committee rated all deaths as cardiovascular or noncardiovascular and as SCD or non-SCD. In total, 96 women (11%) died over a median of 6 years (maximum: 8 years). Among 65 cardiovascular deaths, 42% were SCD. Mortality per 1000 person-hours increased linearly with CAD severity (no CAD: 5.8; minimal: 15.9; obstructive: 38.6; P< 0.0001). However, the proportion of SCD was similar across CAD severity: 40%, 58%, and 38% for no, minimal, and obstructive CAD subgroups, respectively (P value not significant). In addition to traditional risk factors (age, diabetes mellitus, smoking), a history of depression (P = 0.018) and longer corrected QT interval (P = 0.023) were independent SCD predictors in the entire cohort. Corrected QT interval was an independent predictor of SCD in women without obstructive CAD (P = 0.033). Conclusions-SCD contributes substantially to mortality in women with and without obstructive CAD. Corrected QT interval is the single independent SCD risk factor in women without obstructive CAD. In addition to management of traditional risk factors, these data indicate that further investigation should address mechanistic understanding and interventions targeting depression and corrected QT interval in women.
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