Weiden/Munich. Sudden cardiac death is one of the most common causes of death in western industrialized countries. The Medical Clinic II of the Klinikum Weiden was an important cooperation partner in a wide-ranging study by the German Center for Cardiovascular Research, which has now been published in “The Lancet”, one of the most important specialist magazines.
From editorial
Prof. Dr. Robert HG Schwinger, Chief Physician of the Medical Clinic II at the Klinikum Weiden. Photo: Kliniken Nordoberpfalz
More than 11,000 patients were screened for the study, but only approximately 1,330 patients were enrolled in the study. “That alone shows the great effort behind the study,” emphasizes Prof. Dr. Robert Schwinger, Chief Physician of the Medical Clinic II at the Klinikum Weiden. Data from 44 patients at the Klinikum Weiden could also be used for the study.
pumping capacity of the heart
The decisive factor for inclusion in the study was the so-called EF value (ejection fraction or pumping capacity of the heart) of patients after a heart attack. In healthy people, this value is usually well over 50 percent, in people with severe heart failure below 35 percent.
“Implantation of a defibrillator is only recommended in patients with severely impaired pumping capacity of the left ventricle, i.e. an EF value of less than 35 percent. However, a significant proportion of cardiac-related deaths also occur in patients who have only a mild to moderately impaired pump function, i.e. an EF between about 40 and 50 percent. These patients are not taken into account by the current guidelines,” says the head of the Cardiology Center at Weiden Clinic.
High-risk group heart attack patients
The focus of the study was therefore the intermediate area between a very poor and no longer normal pump function of the heart in patients after a heart attack. The SMART-MI-DZHK9 study examined whether a new high-risk group among heart attack patients with mildly to moderately impaired pumping function of the heart could be identified using previously defined ECG criteria. For this purpose, the data from implantable cardiac monitors (ICM, insertable cardiac monitors) were evaluated.
“It was shown that the established ECG criteria were very effective in detecting serious cardiac arrhythmias that pose a risk to these patients. Patients in this new risk group have a similarly poor prognosis as patients with a severely restricted pump function,” explains Prof. Dr. Robert Schwinger.
reduce risk for this group
With the data collected in the study, it can now be clarified in the next step how the risks for patients in this group can be reduced. “This study shows once again that modern clinical research is only possible in a network. We are pleased that we can make an important contribution in addition to many university clinics and heart centers throughout Germany and underlines the close contact and the constructive and trusting cooperation with the LMU Munich Klinikum Großhadern and the cardiology and heart surgery department there,” says the Weiden chief physician.
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