open access

Vol 17, No 1 (2010)
Review articles
Published online: 2010-01-26
Submitted: 2013-01-14
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Pathophysiology, risk stratification, and management of sudden cardiac death in coronary artery disease

Nabil El-Sherif, Abdullah Khan, Joseph Savarese, Gioia Turitto
Cardiol J 2010;17(1):4-10.

open access

Vol 17, No 1 (2010)
Review articles
Published online: 2010-01-26
Submitted: 2013-01-14

Abstract

Management of sudden cardiac death (SCD) is undergoing radical change in direction. It is becoming increasingly appreciated that besides depressed left ventricular systolic function and the conventional risk stratification tools, new markers for plaque vulnerability, enhanced thrombogenesis, specific genetic alterations of the autonomic nervous system, cardiac sarcolemmal and contractile proteins, and familial clustering may better segregate patients with atherosclerotic coronary artery disease (CAD) who are at high risk of SCD from those who may suffer from nonfatal ischemic events. Better understanding of pathophysiologic processes such as post-myocardial infarction remodeling, the transition from compensated hypertrophy to heart failure, and the increased cardiovascular risk of CAD in the presence of diabetes or even a pre-diabetic state will help to improve both risk stratification and management. The rapidly developing fields of microchips technology, and proteomics may allow rapid and cost-effective mass screening of multiple risk factors for SCD. The ultimate goal is not only to change the current direction of management strategy of SCD away from increased ICD utilization, but to identify novel methods for risk stratification, risk modification, and prevention of SCD that could be applied to the general public at large.
(Cardiol J 2010; 17, 1: 4-10)

Abstract

Management of sudden cardiac death (SCD) is undergoing radical change in direction. It is becoming increasingly appreciated that besides depressed left ventricular systolic function and the conventional risk stratification tools, new markers for plaque vulnerability, enhanced thrombogenesis, specific genetic alterations of the autonomic nervous system, cardiac sarcolemmal and contractile proteins, and familial clustering may better segregate patients with atherosclerotic coronary artery disease (CAD) who are at high risk of SCD from those who may suffer from nonfatal ischemic events. Better understanding of pathophysiologic processes such as post-myocardial infarction remodeling, the transition from compensated hypertrophy to heart failure, and the increased cardiovascular risk of CAD in the presence of diabetes or even a pre-diabetic state will help to improve both risk stratification and management. The rapidly developing fields of microchips technology, and proteomics may allow rapid and cost-effective mass screening of multiple risk factors for SCD. The ultimate goal is not only to change the current direction of management strategy of SCD away from increased ICD utilization, but to identify novel methods for risk stratification, risk modification, and prevention of SCD that could be applied to the general public at large.
(Cardiol J 2010; 17, 1: 4-10)
Get Citation

Keywords

sudden cardiac death cascade; diabetes and sudden cardiac death; the autonomic nervous system; post infarction remodeling; systolic dysfunction; genetics

About this article
Title

Pathophysiology, risk stratification, and management of sudden cardiac death in coronary artery disease

Journal

Cardiology Journal

Issue

Vol 17, No 1 (2010)

Pages

4-10

Published online

2010-01-26

Bibliographic record

Cardiol J 2010;17(1):4-10.

Keywords

sudden cardiac death cascade
diabetes and sudden cardiac death
the autonomic nervous system
post infarction remodeling
systolic dysfunction
genetics

Authors

Nabil El-Sherif
Abdullah Khan
Joseph Savarese
Gioia Turitto

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