SUDDEN CARDIAC DEATH

Predictors of SCD Post MI Change With Time

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Predictors of Sudden Cardiac Death Change With Time After Myocardial Infarction: Results From the VALIANT Trial

Results: SCD occurred in 8.6% of patients during 3 years of follow-up. During the initial hospitalization for MI, the strongest predictors of SCD were atrial fibrillation (AF) (hazard ratio [HR], 2.0), prior stroke (HR, 2.0), and smoking (HR, 1.5). In the first 30 days after MI, the strongest predictors of SCD were recurrent MI (HR, 3.5), rehospitalization (HR, 2.5), and coronary artery bypass graft surgery (HR, 2.3). The strongest predictors of SCD from 30 days to 6 months after MI were prior transient ischemic attack (HR, 1.8), prior diabetes (HR, 1.7), and new left bundle branch block (HR, 1.7). From 6 months to 3 years after MI, the strongest predictors of SCD were prior MI (HR, 1.7), recurrent MI (HR, 1.7), and AF (HR, 1.6).

 

Meet the New Boss – Same as the Old Boss

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Medical News: Risk of Sudden Death No Less Likely with Atypical Antipsychotics – in Psychiatry, Schizophrenia from MedPage Today

Here is another report on the same Vanderbilt University study on antipsychotics originally reported on in the NEJM.  The lesson from this comparison is obvious.  Be cognizant of differences in reporting quality and possible underlying biases.  The NYT article didn’t go deep enough.  The sudden cardiac death risk from newer antipsychotics is about the same as the sudden death risk from older antipsychotics.

Same study, different perspectives.  I’ll leave it to the reader to determine which is the better report.

Add +50 Debits up to Decline

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The connection between OSA and SCD is getting stronger according to a recent study by the Mayo Clinic.  This information has profound implications for how life underwriters approach this combination of impairments.  When I started in the profession last century, not much thought (or rating) was given to OSA.  Times have changed and we now know more about the risk. 

Will we use this new data or once again succumb to market forces?