Coronary Stenosis Location, Revascularization Strategy, and Sudden Cardiac Death in Chronic and Acute Coronary Syndromes
Authors' conclusion
Left main and RCA stenoses were associated with the greatest SCD risk, with vessel-specific risk modified by revascularization strategy.
Study context
- Population
- Consecutive patients undergoing coronary angiography for suspected/known CAD or ACS, Tampere Heart Hospital, Finland, 2007–20181,048 sudden cardiac death (SCDs)
- Participants
- 12,695 vs 9,800
- Exposure
- Coronary stenosis location
- Elective coronary angiographyn = 12,695
- Acute coronary syndromen = 9,800
- Outcome
- SCD or equivalent events (fatal SCD, resuscitated SCD, or adequate ICD therapy for ventricular arrhythmia with hemodynamic collapse)
- Follow-up
- Median 8.1 years (Q1-Q3: 5.1-11.6 years)
Methodological detailsregistry of consecutive patients, single-centre, Median follow-up 8.1 years (Q1-Q3: 5.1-11.6 years)
- Registry of consecutive patients
- Single-centre
- Median follow-up 8.1 years (Q1-Q3: 5.1-11.6 years)
Main finding
As reported in the abstract
SCD by stenosis location (adjusted)
Hazard ratio (95% CI)P value
RCA stenosis
1.53(1.31–1.80)
P < 0.001Left circumflex stenosis
1.34(1.15–1.57)
P < 0.001Observational data: associations, not effects.
Further findings
SCD with left anterior descending coronary artery stenosis in patients with acute coronary syndromes (subgroup)
| HR (95% CI) | P value | ||
|---|---|---|---|
| Left anterior descending coronary artery stenosisAcute coronary syndromes | 1.37 (1.09–1.72) | P = 0.007 | |
| 0.512Hazard ratio (log scale) |
SCD by stenosis site and revascularization strategy (subgroup)
| HR (95% CI) | P value | ||
|---|---|---|---|
| Left main stenosisNoninvasively managed patients | 1.53 (1.03–2.27) | P = 0.036 | |
| 0.512Hazard ratio (log scale) |
- Right coronary artery (RCA) stenosis was associated with the highest risk in percutaneous coronary intervention-treated patients
- No stenosis site was associated with excess risk after coronary artery bypass graft
Original publication
Coronary Stenosis Location, Revascularization Strategy, and Sudden Cardiac Death in Chronic and Acute Coronary Syndromes. JACC Cardiovasc Interv. Published 25 May 2026. doi:10.
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