Vaduganathan M, et al. - Researchers determined the incidence, timing, and clinical predictors of sudden cardiac death (SCD) following hospitalization for heart failure with reduced ejection fraction (HFrEF, ≤40%) in the EVEREST trial. Risks of 1-year post-discharge SCD of 7% were reported for patients hospitalized for HFrEF. These risks accrued gradually over time and were balanced with high competing risks of non-sudden death (17%). SCD risk could not be adequately predicted by traditional clinical characteristics.

Methods

• Using multiple logistic regression analyses, >30 baseline covariates (including treatment randomization, demographics, comorbid conditions, natriuretic peptides, EF, medical and device therapies) were tested to determine predictors of 1-year SCD.

Results

• During median 9.9 months follow-up in 4,024 (97%) trial patients discharged alive, 268 (7%) SCD and 703 (17%) non-SCD deaths were reported.
• At baseline, implantable cardioverter-defibrillator use was 14.5%.
• As per findings, estimates of SCD at 1-, 3-, 6-, and 12-months were 0.8%, 2.3%, 4.1%, and 7.4%, respectively.
• Prior to SCD, readmission was reported for most patients (n=147, 55%).
• Male sex, black race, diabetes mellitus, and angiotensin-converting enzyme inhibitor/angiotensin II receptor blocker use were identified as potential predictors of 1-year SCD after hospitalization for HFrEF (all P <0.10), however this final model showed poor discrimination (C-statistic 0.57).