First month after heart attack crucial:
Study by Eric Nagourney. (New York)
Possibilty of a second heart attack four times higher
People who survive a heart attack are at much higher risk of sudden cardiac death in the next 30 days, researchers have found. The findings suggest that doctors need to closely supervise patients in the month after a heart attack, and that patients also need to be alert to signs of trouble.
"The first month after a heart attack can be envisioned as a period of healing with heart tissue remodelling, which conceptually is associated with a propensity to experience sudden death," one of the authors, Dr Véronique L. Roger of the Mayo Clinic in Rochester , said.The researchers, led by Selcuk Adabag of the Veterans Affairs Medical Centre in Minneapolis , followed the health of almost 3,000 people who had a heart attackfrom 1979 to 2005.
In the first 30 days, they found, the rate of sudden cardiac death was 1.2%, about four times the risk that would have been expected in the general population, once age and sex were taken into account. But the rate improved greatly over the following 11 months, dropping to a level lower than that usually seen in the general population.
In fact, over all, the study found big improvements in the rate of sudden cardiac death for heart attack patients in the past three decades. The decline, the researchers said, was more than 40%. They attributed that to improved treatment