Abstract 10093: Incidence of Sudden Cardiac Death After Percutaneous Coronary Intervention

Abstract

Introduction: Sudden cardiac death (SCD) remains a major concern for the patients that undergo percutaneous coronary intervention (PCI). We sought to investigate the incidence and contributing clinical factors of SCD after PCI. Methods: We analyzed 8791 consecutive patients who underwent PCI between 2008 and 2019 from 15 institutions, and evaluated the cumulative incidence of SCD after PCI. The cause of death was adjudicated by an independent event committee. SCD was defined as unexpected death without a non-cardiovascular case in a previously stable patient within 24 hours from the onset. Cox proportional hazards modeling was used with the Fine and Gray method to account for competing SCD risk. Results: In the present cohort, the mean age was 68.3±11.3 years, and the prevalence of previous heart failure (HF), which was ascertained from hospital records regardless of systolic function status, was 4.6%. Of these, 4592 (52.2%) underwent PCI for acute coronary syndrome (ACS). The cumulative incidence of all-cause death and SCD was 3.47% and 0.44%, respectively in 2 years. SCDs occurred more frequently immediately after PCI in ACS patients; however, the total incidence of SCD was similar in ACS and stable coronary artery disease (CAD) patients at 2 years (0.45% vs 0.44%, p = 0.91 for log-rank test) (Figure). Overall, presence of previous HF was associated with risk of SCD (crude incidence [vs. non-heart failure patients] 2.29 vs. 0.29%; adjusted hazard ratio 6.60, 95% CI 3.09-14.1, p<0.01) rather than clinical presentation (e.g. ACS vs. stable CAD; adjusted hazard ratio 1.29, 95% CI 0.65-2.54, p=0.47). Conclusions: The cumulative incidence of SCD was ~0.5% in the contemporary multicenter PCI registry. Rather than the clinical presentation, the presence of previous HF was associated with a higher risk of SCD.