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Sudden cardiac death (SCD) is one of the greatest problems in
modern cardiology because of its dramatic presentation and the socio-economic implications due to a large
number of cases that occur. Recent reports have shown that about 80% of cases take place in patients
(pts) with coronary artery disease (CAD)1. Despite significant progress in the treatment and prevention of
cardiovascular diseases the incidence and prevalence of heart failure (HF) have been increasing steadily in
recent years, especially in elderly. The most common cause of chronic HF is no longer hypertension or
valvular heart disease, as it was in past decades, but rather CAD. In 13 multicenter heart failure treatment
trials reported over the past 10 years, involving >20.000 pts, CAD was the underlying etiology of HF in
nearly 70% of the pts. The importance of CAD is nevertheless underestimated due to the fact that the
prognosis of pts with HF and CAD is considerably worse than that of pts without CAD2.
The mode of death in patients with HF as SCD has been reported in the range of 35-50%3. The same
results can also be seen in our group of pts after AMI treated in the University Medical Centre in Ljubljana
(Tab. I).
TABLE I
After AMI
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1067 pts
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M: 770 (72%)
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C:\WWW 297 (28%)
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All pts with HF
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427 pts (40%)
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M: 279 (36%)
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F. 148 (50%)
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All cardiac deaths in HF
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181pts (42%)
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M: 116 (42%)
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C:\WWW 65 (44%)
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SCD in HF
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81 pts (45%)
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M: 54 (47%)
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C:\WWW 27 (42%)
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M=male; F=female
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