Trappe H J, Hartwig C A, Klein H, Wenzlaff P, Lichtlen P R
Abteilung Kardiologie, Medizinische Hochschule Hannover.
Z Kardiol. 1988 Jul;77(7):436-43.
214 patients with single vessel disease (high grade stenosis greater than or equal to 75% or occlusion of the LAD, RCA or LCX) were followed for 1-78 months, average 51 months. Incidence of sudden death was studied in relation to coronary artery lesions, left ventricular wall motion and ventricular arrhythmias found during ambulatory ECG monitoring at the time of angiography. Incidence of sudden death was 11.1% (16/144) in LAD, 7.3% (4/55) in RCA and 6.7% (1/15) in LCX lesions. Coronary artery occlusion was associated with a significantly higher incidence of sudden death (14.6%, 18/123) than high-grade stenosis (3.3%, 3/91) (p less than 0.05). The risk of sudden death increased markedly in patients with complex arrhythmias and an occluded LAD or RCA (21.0%, 8/38; 18.2%, 2/11) compared to patients without complex arrhythmias (14.7%, 5/34; 5.5%, 1/18) (p = ns). Only one patient (1/15, 6.7%) with an isolated LCX lesion died suddenly. Our data show that the incidence of sudden death over 51 months is relatively low in patients with single vessel disease. However, LAD occlusion or RCA lesion with akinetic left ventricular areas and complex arrhythmias are independent predictors of sudden death.