Arrhythmias & electrophysiology
Sudden cardiac death after myocardial infarction: individual participant data from pooled cohorts
An erratum to this article was published (Eur Heart J, 16 Jun 2026 ↗)
Authors' conclusion
More accurate risk stratification for sudden cardiac death and identification of low-risk individuals with severely reduced LVEF or of high-risk individuals with preserved LVEF was not feasible, neither using LVEF nor using other predictors.
Study context
- Population
- Post-MI patients20 data sets
- Participants
- 140,204 patients
- Comparison
- Implantable cardioverter-defibrillator (ICD) vs non-ICD patients ≤ 35% vs non-ICD patients >35%
- ICDn = 7,543
- non-ICD patients ≤ 35%n = 25,058
- non-ICD patients >35%n = 107,603
- Outcome
- Sudden cardiac death or, in defibrillator carriers, appropriate defibrillator therapy
Methodological details20 data sets, competing risk framework, internal-external cross-validation, random effect meta-analysis
- 20 data sets
- Competing risk framework
- Internal-external cross-validation
- Random effect meta-analysis
Pooled result
As reported in the abstract
SCD prediction by LVEF
| Group | Value | Mean follow-up |
|---|---|---|
| ICD | 1326 events | 30.0 months |
| non-ICD patients ≤ 35% | 1193 events | 46.5 months |
| non-ICD patients >35% | 1567 events | 57.6 months |
Value
ICD1326 events
non-ICD patients ≤ 35%1193 events
non-ICD patients >35%1567 events
Mean follow-up
ICD30.0 months
non-ICD patients ≤ 35%46.5 months
non-ICD patients >35%57.6 months
- Left ventricular ejection fraction (LVEF) poorly predicted SCD in all three subgroups (c-statistics)
- between 0.50 and 0.56
Original publication
Sudden cardiac death after myocardial infarction: individual participant data from pooled cohorts. Eur Heart J. Published 8 October 2024. doi:10.
Summarised from the published abstract; every number is checked against it