30 days after heart attack remain crucial for patients

Though there has been substantial improvement in the treatment of heart attacks yet 30 days after heart attack remain crucial for the patients. The patient can face sudden death during these 30 days.

A. Selcuk Adabag, M.D., M.S., of Veterans Affairs Medical Center, Minneapolis, and colleagues at Mayo Clinic, Rochester, Minn. conducted a study 2,997 residents (average age 67, 59 percent men) who had a heart attack in Olmsted County, Minn., between 1979 and 2005.

"There were two main aspects of the study that we did not necessarily anticipate. One was how much the risk of sudden death after a heart attack has decreased over time. The magnitude of decline was 40 percent over the study period. The second was that if a patient experienced heart failure at any time during the follow-up, the risk of sudden death increased substantially," said Dr. Veronique Roger, a professor of medicine and epidemiology at the Mayo Clinic, and lead author of the report published in the Nov. 5 issue of the Journal of the American Medical Association.

It was found that during the 30-days post heart attack, incidence of sudden cardiac death was 1.2 percent. This is four times higher than expected. The cumulative five-year incidence of sudden cardiac death among heart attack patients was 6.9 percent.

"In the community, the risk of sudden cardiac death is the highest during the first month after myocardial infarction when it markedly exceeds the rate in the general population," the authors conclude. "Among 30-day survivors, the risk of sudden cardiac death declines rapidly but it is markedly increased by the occurrence of heart failure during follow-up. This underscores the importance of continued surveillance of patients after myocardial infarction and the dynamic nature of risk stratification."