Risk indicators for out-of-hospital cardiac arrest in patients with coronary artery disease

The objective of this study was to identify risk factors for sudden cardiac arrest (SCA) in patients with coronary artery disease (CAD). A retrospective case-control study was performed consisting of a group of unselected patients who had suffered SCA and had a clinical history of CAD, and a group of unselected age- and gender-matched CAD control patients living in the region of Maastricht. Information about previous myocardial infarction (MI), left ventricular ejection fraction (LVEF), hypertension, hypercholesterolemia, diabetes mellitus, smoking, and coffee and alcohol consumption was collected. A logistic regression model was fitted to all mentioned variables including age and genders. Included were 117 SCA cases (84% men, mean age 65 years [+/- 7]) and 144 control patients (83% men, mean age 63 years [+/-8]). Previous MI (odds ratio [OR] 4.0, 95% confidence interval [CI] 1.7-93), hypertension (OR 2.9, 95% CI 1.5-6.1), heavy coffee consumption (>10 cups per day) (OR 55.7, 95% CI 6.4-483), and a LVEF < 40% (OR 11.2, CI 4.4-28.5) were independent risk indicators for SCA in patients with CAD. Alcohol consumption (1-21 glasses per week) seemed to protect patients with CAD from SCA (OR 0.5, 95% CI 0.2-0.98). These observations suggest that changes in lifestyle factors can be of potential importance in protecting patients with CAD from dying suddenly. (C) 1999 Elsevier Science Inc.