MADIT-II and its implications.

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Abstract
The major risks associated with coronary disease are angina, acute myocardial infarction, reduced cardiac function as manifest by depressed left ventricular ejection fraction and congestive heartfailure, and sudden arrhythmogenic cardiac death. During the past three decades, considerableadvances have been made in the management of patients with coronary heart disease with beta-blockers, calcium-channel blockers, angiotensin converting-enzyme (ACE) inhibitors, angiotensin receptor blockers, thrombolytics, balloon-stentangioplasty, and coronary artery bypass graftsurgery. The clinical course of patients with coronary disease has been meaningfully improved by these therapies, but sudden cardiac death remains a major problem and has not been impacted by these therapeutic interventions. Recently, the Center for Disease Control reported that more than 460 000 sudden cardiac deaths occur annually in the U.S., with sudden cardiac death accounting for 63% of all cardiac mortality events.1

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