Aziz Emad F, Javed Fahad, Pratap Balaji, Herzog Eyal
The Advanced Cardiac Admission Program, St Luke's-Roosevelt Hospital Center, University Hospital of Columbia University, College of Physicians and Surgeons, New York, NY, USA.
Open Access Emerg Med. 2010 Dec;2010(2):99-114. doi: 10.2147/OAEM.S6869.
Cardiovascular diseases account for 40% of all deaths in the West. Sudden cardiac death (SCD) is a major health problem affecting over 300,000 patients annually in the United States alone. Presence of coronary artery disease (CAD), usually in the setting of diminished left ventricular ejection fraction, is still the single major risk factor for SCD. Additionally, acute myocardial ischemia, structural cardiac defects, anomalous coronary arteries, cardiomyopathies, genetic mutations, and ventricular arrhythmias are all attributed to SCD, demonstrating the perplexity of this condition. With the recent advancements in cardiovascular medicine, the incidence of SCD is expected to increase steeply as the prevalence of CAD and heart failure is uprising in general population. Considering SCD, the major challenge confronting contemporary cardiology, multiple strategies for prevention against SCD have been developed. β-blockers have been shown to reduce the risk of SCD, whereas implantable cardioverter-defibrillator devices are found to be effective at terminating the malignant arrhythmias. In recent years, multiple clinical trials were carried out to identify patients who may benefit from preventive intervention, including medical therapy and automatic cardioverter-defibrillator implantations. This review article provides insight into the advanced strategies for the prevention and treatment of SCD based on the data available in medical literature to date.
心血管疾病占西方所有死亡人数的40%。仅在美国，心源性猝死（SCD）就是一个重大的健康问题，每年影响超过30万名患者。冠状动脉疾病（CAD）的存在，通常在左心室射血分数降低的情况下，仍然是SCD的单一主要危险因素。此外，急性心肌缺血、心脏结构缺陷、冠状动脉异常、心肌病、基因突变和室性心律失常都与SCD有关，这表明了这种情况的复杂性。随着心血管医学的最新进展，由于CAD和心力衰竭在普通人群中的患病率不断上升，预计SCD的发病率将急剧增加。考虑到SCD是当代心脏病学面临的主要挑战，已经制定了多种预防SCD的策略。β受体阻滞剂已被证明可降低SCD的风险，而植入式心脏复律除颤器被发现对终止恶性心律失常有效。近年来，开展了多项临床试验，以确定可能从预防性干预中受益的患者，包括药物治疗和自动心脏复律除颤器植入。这篇综述文章根据迄今为止医学文献中的数据，深入探讨了预防和治疗SCD的先进策略。
