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Survivors of ventricular fibrillation have persistent cardiovascular risk factors late in follow-up

Author
Organization
Abstract
Objective: Implantable cardioverter-defibrillators (ICDs) prevent arrhythmic death, but do not modify disease progression. The prevalence of persistent cardiovascular risk factors in patients receiving an ICD and their adherence to optimal pharmacological therapy at late follow-up is unknown. The aim of this study was to assess the prevalence of cardiovascular and specific sudden cardiac arrest (SCA) risk factors, and the pharmacological treatment in ICD recipients who survived SCA caused by ventricular fibrillation (VF). Design: Cross-sectional study. A total of 100 consecutive ICD patients who survived SCA due to documented VF, not due to a transient or reversible cause or an arrhythmogenic disease, were interviewed and examined at the routine outpatient clinic. Results: The mean age of the patients was 60 +/- 11 years, and they were analysed at a median interval of 1092 days after SCA. The majority of patients had coronary artery disease. The New York Heart Association class at the time of implantation was >= II in 62%. A single chamber device was used in 49% and a resynchronization device in 12%. At the routine control, the most prevalent risk factors were overweight or obesity (63%), hypertension (41%), and smoking (16%). Pharmacological therapy was suboptimal in 18 -32% of the patients. Eight per cent of the patients had known diabetes and 29% had elevated HbA1c levels. While only 7% had pre-existing overt heart failure, 43% had N-terminal pro-brain natriuretic peptide levels >= 100 pmol/l. High sensitivity C-reactive protein was >= 3 mg/l in 52% of the patients. Family history was positive for sudden cardiac death (SCD) in 46% of the patients. Conclusions: Despite regular medical consultation, a large proportion of the patients had persistent cardiovascular risk factors and were often suboptimally treated. Unexpectedly, latent heart failure and unrecognized diabetes are observed in a large proportion of the patients, as well as elevated inflammatory markers. Genetic analysis may be rewarding, as 46% of the patients had a family history of SCD. Full medical attention, optimizing drug therapy, and counselling of these patients is necessary.
Keywords
Biomarkers, cardiovascular risk factors, family history, implantable cardioverter-defibrillator, sudden cardiac arrest, ventricular fibrillation, SUDDEN CARDIAC DEATH, DEFIBRILLATORS AVID TRIAL, C-REACTIVE PROTEIN, IMPLANTABLE CARDIOVERTER-DEFIBRILLATORS, HEART-RATE-VARIABILITY, LIPID-LOWERING DRUGS, MYOCARDIAL-INFARCTION, ANTIARRHYTHMICS, ARRHYTHMIAS, DISEASE

Citation

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MLA
Smith, Tim et al. “Survivors of Ventricular Fibrillation Have Persistent Cardiovascular Risk Factors Late in Follow-up.” EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY 20.1 (2013): 161–167. Print.
APA
Smith, Tim, Theuns, D. A., Muskens-Heemskerk, A., Deckers, J. W., & Jordaens, L. (2013). Survivors of ventricular fibrillation have persistent cardiovascular risk factors late in follow-up. EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY, 20(1), 161–167.
Chicago author-date
Smith, Tim, Dominic AMJ Theuns, Agnes Muskens-Heemskerk, Jaap W Deckers, and Luc Jordaens. 2013. “Survivors of Ventricular Fibrillation Have Persistent Cardiovascular Risk Factors Late in Follow-up.” European Journal of Preventive Cardiology 20 (1): 161–167.
Chicago author-date (all authors)
Smith, Tim, Dominic AMJ Theuns, Agnes Muskens-Heemskerk, Jaap W Deckers, and Luc Jordaens. 2013. “Survivors of Ventricular Fibrillation Have Persistent Cardiovascular Risk Factors Late in Follow-up.” European Journal of Preventive Cardiology 20 (1): 161–167.
Vancouver
1.
Smith T, Theuns DA, Muskens-Heemskerk A, Deckers JW, Jordaens L. Survivors of ventricular fibrillation have persistent cardiovascular risk factors late in follow-up. EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY. 2013;20(1):161–7.
IEEE
[1]
T. Smith, D. A. Theuns, A. Muskens-Heemskerk, J. W. Deckers, and L. Jordaens, “Survivors of ventricular fibrillation have persistent cardiovascular risk factors late in follow-up,” EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY, vol. 20, no. 1, pp. 161–167, 2013.
@article{8101427,
  abstract     = {Objective: Implantable cardioverter-defibrillators (ICDs) prevent arrhythmic death, but do not modify disease progression. The prevalence of persistent cardiovascular risk factors in patients receiving an ICD and their adherence to optimal pharmacological therapy at late follow-up is unknown. The aim of this study was to assess the prevalence of cardiovascular and specific sudden cardiac arrest (SCA) risk factors, and the pharmacological treatment in ICD recipients who survived SCA caused by ventricular fibrillation (VF). 
Design: Cross-sectional study. A total of 100 consecutive ICD patients who survived SCA due to documented VF, not due to a transient or reversible cause or an arrhythmogenic disease, were interviewed and examined at the routine outpatient clinic. 
Results: The mean age of the patients was 60 +/- 11 years, and they were analysed at a median interval of 1092 days after SCA. The majority of patients had coronary artery disease. The New York Heart Association class at the time of implantation was >= II in 62%. A single chamber device was used in 49% and a resynchronization device in 12%. At the routine control, the most prevalent risk factors were overweight or obesity (63%), hypertension (41%), and smoking (16%). Pharmacological therapy was suboptimal in 18 -32% of the patients. Eight per cent of the patients had known diabetes and 29% had elevated HbA1c levels. While only 7% had pre-existing overt heart failure, 43% had N-terminal pro-brain natriuretic peptide levels >= 100 pmol/l. High sensitivity C-reactive protein was >= 3 mg/l in 52% of the patients. Family history was positive for sudden cardiac death (SCD) in 46% of the patients. 
Conclusions: Despite regular medical consultation, a large proportion of the patients had persistent cardiovascular risk factors and were often suboptimally treated. Unexpectedly, latent heart failure and unrecognized diabetes are observed in a large proportion of the patients, as well as elevated inflammatory markers. Genetic analysis may be rewarding, as 46% of the patients had a family history of SCD. Full medical attention, optimizing drug therapy, and counselling of these patients is necessary.},
  author       = {Smith, Tim and Theuns, Dominic AMJ and Muskens-Heemskerk, Agnes and Deckers, Jaap W and Jordaens, Luc},
  issn         = {2047-4873},
  journal      = {EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY},
  keywords     = {Biomarkers,cardiovascular risk factors,family history,implantable cardioverter-defibrillator,sudden cardiac arrest,ventricular fibrillation,SUDDEN CARDIAC DEATH,DEFIBRILLATORS AVID TRIAL,C-REACTIVE PROTEIN,IMPLANTABLE CARDIOVERTER-DEFIBRILLATORS,HEART-RATE-VARIABILITY,LIPID-LOWERING DRUGS,MYOCARDIAL-INFARCTION,ANTIARRHYTHMICS,ARRHYTHMIAS,DISEASE},
  language     = {eng},
  number       = {1},
  pages        = {161--167},
  title        = {Survivors of ventricular fibrillation have persistent cardiovascular risk factors late in follow-up},
  url          = {http://dx.doi.org/10.1177/1741826711432031},
  volume       = {20},
  year         = {2013},
}

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