Predictive value of Shanghai score system in patients with drug-induced type 1 Brugada electrocardiographic pattern
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: The Shanghai score system was developed to enhance the risk stratification in Brugada Syndrome (BrS); however, its prognostic value in drug-induced type 1 BrS remains unclear. METHODS: This study involved 698 patients with drug-induced type 1 BrS, confirmed via pharmacologic challenge (flecainide or ajmaline), from 21 centers in Italy and Switzerland. Patients were classified according to the Shanghai score system: probable/definite BrS (score ≥ 3.5) and possible BrS (score < 3.5). The primary outcome was appropriate ICD therapy or sudden cardiac death (SCD)/sustained ventricular arrhythmias; the secondary outcome includes the identification of clinical predictors of primary outcome events. Kaplan-Meier and Cox regression analyses were used. RESULTS: Our study population included 239 patients (34.2%) with probable/definite BrS and 459 (65.8%) patients with possible BrS. During a median follow-up of 57.4 months, 20 patients (2.9%) experienced the primary outcome. Kaplan-Meier analysis revealed a significantly lower event rate in possible BrS (0.11% over 10 years) compared to probable/definite BrS (0.42%). SCN5A pathogenic variants were a significant predictor of primary endpoint in the possible BrS group (OR: 12.5). CONCLUSIONS: Shanghai score system for BrS diagnosis may be useful as a tool for risk stratification of life-threatening arrhythmias among patients with drug-induced type I BrS ECG. Identifying the SCN5A mutations is of pivotal importance for refining the risk stratification.
Source: Clinical Research in Cardiology
Authors: Vincenzo Russo, Alfredo Caturano, Federico Migliore, Federico Guerra, Pietro Francia, Martina Nesti, Giulio Conte, Alessandro Paoletti Perini, Giuseppe Mascia, Stefano Albani, Procolo Marchese, Vincenzo Ezio Santobuono, Gregory Dendramis, Andrea Rossi, Andrea Ottonelli Ghidini, Pasquale Notarstefano, Luigi Sciarra, Zefferino Palamà, Enrico Baldi, Roberto Floris, Gerardo Nigro, IBRYD Study Group, Emilio Attena, Emanuele Romeo, Antonio D’Onofrio, Carmen Adducci, Livia Pardo Franchetti, Nicola Berlier, Berardo Sarubbi, Ferdinando Carlo Sasso, Paolo Golino, Alessandro Vicentini, Luca Barca, Italo Porto, Nicolò Martini, Chiara Carrozzi, Gianfranco Tola
Institutions: University of Campania "Luigi Vanvitelli", San Raffaele University of Rome, University of Padua, Marche Polytechnic University, Azienda Ospedaliera Sant'Andrea, Sapienza University of Rome, Fondazione Toscana Gabriele Monasterio, Ente Ospedaliero Cantonale, Istituto Cardiocentro Ticino, Università della Svizzera italiana, Santa Maria Nuova Hospital, Azienda Usl Toscana Centro, Ospedale Policlinico San Martino, University of Bari Aldo Moro, Ospedale Versilia, Ospedale San Donato, University of L'Aquila, Policlinico San Matteo Fondazione
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,190
OpenAlex ID: W4414523760