Abstract
Background: Recent studies show that coronary revascularization in myocardial infarction (MI) patients improves survival, but its effect on sudden cardiac death (SCD) remains unclear. This study assessed the impact of complete anatomical revascularization at varying post-MI intervals on the dynamics of non-in vasive risk factors (NIRFs) for SCD.
Methods and Results: A total of 110 post-MI patients with preserved or moderately reduced left ven tricular ejection fraction (LVEF) underwent percutaneous coronary intervention (PCI) 40 days after MI. Based on the time from MI to PCI, patients were divided into two groups: Early revascularization (n=55, median 67.5 days) and Late revascularization (n=55, median 580 days). Six NIRFs were assessed by 24-hour Holter ECG monitoring before and one year after PCI: ventricular ectopy (VE) >10/hour, non-sustained ventricular tachycardia (NSVT), potentially life-threatening VE (PLTVE), reduced heart rate variability (HRV), abnormal heart rate turbulence (HRT), and prolonged QTc. Reduced HRV was most common (90%). One year later, early revascularization significantly reduced total NIRFs, notably PLTVE (p=0.043) and VE (p=0.038), compared to late PCI.
Conclusion: Early complete anatomical revascularization post-MI in patients with preserved or mildly reduced LVEF is linked to greater improvement in NIRFs for SCD, suggesting early ischemia relief may better modify the arrhythmogenic substrate.
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