多くの心臓突然停止には前兆の警戒徴候を有する （Abstract: 18987）

心臓突然停止を来した男性の半数以上が過去1か月以内に兆候を有していた
More than half of men who had a sudden cardiac arrest had symptoms up to a month before
心臓突然停止（SCA）は常に突然なわけではないとの研究結果が2013年American Heart Association学会で発表された。中年男性を対象としたスタディにおいて、半数以上の者が心臓突然停止を来す前に最長1か月の間に警告となる徴候の可能性のある症状を有していた。院外で心停止した者のうち生存できたのはわずか9.5%であった。研究者らは、2000～2012年の間に院外心停止を来した35～65歳の男性に関する情報を収集した。院外心停止を来した男性567人中 53%が心停止前に症状を呈していた。症状を有していた者のうち、56%は胸痛、13%は呼吸困難、さらに4%はめまい、失神または動悸を有していた。約80%の症状が心臓突然停止前1時間から4週間前に発現していた。症状は特に、冠動脈疾患（CAD）に関連のない心停止よりもCADに関連した心停止の方が高頻度であった（56% 対 32%、P =0.0005）。既にCADを有していることがわかっていた者では、55%がSCA前に症状を有していた。ほとんどの男性がCADを有していたが、心停止前にその検査を受けていたのは約半数に過ぎなかった。研究者らは現在、同様の研究を女性において行っている。
Full Text

Sudden cardiac arrest (SCA) isn't always so sudden, according to research presented at the American Heart Association's Scientific Sessions 2013.
In a study of middle-age men in Portland, Oregon, more than half had possible warning signs up to a month before their hearts stopped abruptly.

Cardiac arrest patients can sometimes survive if they receive CPR immediately and a defibrillator is used quickly to shock the heart into a normal rhythm. Only 9.5 percent of people who suffer a cardiac arrest outside the hospital survive.

"By the time rescuers get there, it's much too late," said Eloi Marijon, M.D., study lead author and a visiting scientist at Cedars-Sinai Heart Institute in Los Angeles.

The new research is part of the 11-year-old Oregon Sudden Unexpected Death Study, which involves 1 million people in the Portland metro area. Researchers gathered information about the symptoms and health history of men 35 to 65 years old who had out-of-hospital cardiac arrests in 2002-12.

Among 567 men who had out-of-hospital cardiac arrests, 53 percent had symptoms prior to the cardiac arrest. Of those with symptoms, 56 percent had chest pain, 13 percent had dyspnea, and 4 percent had dizziness, syncope or palpitations.

Almost 80 percent of the symptoms occurred between four weeks and one hour before the sudden cardiac arrest.  Symptoms were especially frequent with associated coronary artery disease (CAD) compared to non CAD-related SCA (56% vs. 32%, P =0.0005). Among patients with previously known CAD, 55% had symptoms before SCA.  Most men had coronary artery disease, but only about half had been tested for it before their cardiac arrest.

Researchers are conducting similar work in women.

"The lesson is, if you have these kinds of symptoms, please don't blow them off," said Sumeet Chugh, M.D., senior author and associate director for genomic cardiology at the Cedars-Sinai Heart Institute. "Go see your healthcare provider. Don't waste time."

Co-authors are Kyndaron Reinier, Ph.D., M.P.H.; Audrey Evanado, M.D.; Carmen Teodorescu, M.D., Ph.D.; Kumar Narayanan, M.D.; Adriana Huertas Vazquez, Ph.D.; Harpriya Chugh, B.E.; Katherine Jerger, B.S.; Ronald Mariani, E.M.T.P.; Eric Stecker, M.D., M.P.H.; Karen Gunson, M.D.; and Jonathan Jui, M.D., M.P.H. Author disclosures are on the abstract.

The Centers for Disease Control and Prevention, the American Heart Association and the Doris Duke Charitable Foundation funded the study.