Golsa Joodi1, Joan A Maradey2, Brittany Bogle3, Mojtaba Mirzaei4, Murrium I Sadaf5, Irion Pursell6, Cory Henderson4, John Paul Mounsey6, Ross J Simpson7. 1. Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA. 2. Department of Internal Medicine, Section on Cardiovascular Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA. 3. Senior Data Scientist, Data Science Elite Team, IBM Corporation, Durham, NC, USA. 4. Division of Cardiology, Department of Medicine , University of North Carolina, Chapel Hill, NC, USA. 5. Department of Internal Medicine, Yale University School of Medicine, Waterbury, CT, USA. 6. Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina University, Greenville, NC, USA. 7. Division of Cardiology, Department of Medicine , University of North Carolina, Chapel Hill, NC, USA. ross_simpson@med.unc.edu.
Abstract
BACKGROUND: Sudden death is a public health problem with major impact on society. Coronary artery disease (CAD) is believed to underlie 60-80% of these deaths. While deaths from CAD have decreased in the recent decades, sudden death rates remain unacceptably high. OBJECTIVE: We aimed to assess the prevalence of CAD and its risk factors among 18-64-year-old adults in a population-based case registry of sudden deaths and compare them to a living population from the same geographical area. DESIGN: From 2013 to 2015, all sudden deaths among 18-64-year-old adults in Wake County, NC, were identified (n = 371). A comparison group was formed by randomly selecting individuals from an electronic health record repository of a major healthcare system in the area (N = 4218). MAIN MEASURES: Prevalence of CAD and its risk factors among cases of sudden death and living population across sex and age groups. Odds of sudden death associated with atherosclerotic risk factors and comorbidities. KEY RESULTS: CAD was present in 14.8% of sudden death cases. Among sudden death victims, most risk factors and comorbidities were more common in the older age group, except for obesity which was more common in younger cases, and diabetes which was equally prevalent in younger and older cases. Compared to living population, sudden death cases had higher prevalence of atherosclerotic risk factors across all gender and age groups. Sudden death cases had a numerically higher number of risk factors compared to living population, regardless of age group or presence of CAD. CONCLUSIONS: Coronary artery disease is not common among sudden death cases, but risk factors and comorbidities are prevalent. Our findings support the changing etiology of sudden death. In the absence of clinically diagnosed CAD, use of novel imaging modalities and biomarkers may identify high-risk individuals and lead to prevention of sudden death.
BACKGROUND: Sudden death is a public health problem with major impact on society. Coronary artery disease (CAD) is believed to underlie 60-80% of these deaths. While deaths from CAD have decreased in the recent decades, sudden death rates remain unacceptably high. OBJECTIVE: We aimed to assess the prevalence of CAD and its risk factors among 18-64-year-old adults in a population-based case registry of sudden deaths and compare them to a living population from the same geographical area. DESIGN: From 2013 to 2015, all sudden deaths among 18-64-year-old adults in Wake County, NC, were identified (n = 371). A comparison group was formed by randomly selecting individuals from an electronic health record repository of a major healthcare system in the area (N = 4218). MAIN MEASURES: Prevalence of CAD and its risk factors among cases of sudden death and living population across sex and age groups. Odds of sudden death associated with atherosclerotic risk factors and comorbidities. KEY RESULTS: CAD was present in 14.8% of sudden death cases. Among sudden death victims, most risk factors and comorbidities were more common in the older age group, except for obesity which was more common in younger cases, and diabetes which was equally prevalent in younger and older cases. Compared to living population, sudden death cases had higher prevalence of atherosclerotic risk factors across all gender and age groups. Sudden death cases had a numerically higher number of risk factors compared to living population, regardless of age group or presence of CAD. CONCLUSIONS: Coronary artery disease is not common among sudden death cases, but risk factors and comorbidities are prevalent. Our findings support the changing etiology of sudden death. In the absence of clinically diagnosed CAD, use of novel imaging modalities and biomarkers may identify high-risk individuals and lead to prevention of sudden death.
Entities:
Keywords:
SUDDEN; cardiovascular risk factor; coronary artery disease; sudden death
Authors: Wesley T O'Neal; Amit J Shah; Jimmy T Efird; Pentti M Rautaharju; Elsayed Z Soliman Journal: Am J Cardiol Date: 2014-07-17 Impact factor: 2.778
Authors: M Juhani Junttila; Eeva Hookana; Kari S Kaikkonen; Marja-Leena Kortelainen; Robert J Myerburg; Heikki V Huikuri Journal: Circ Arrhythm Electrophysiol Date: 2016-06
Authors: Daniel Lindholm; Johan Lindbäck; Paul W Armstrong; Andrzej Budaj; Christopher P Cannon; Christopher B Granger; Emil Hagström; Claes Held; Wolfgang Koenig; Ollie Östlund; Ralph A H Stewart; Joseph Soffer; Harvey D White; Robbert J de Winter; Philippe Gabriel Steg; Agneta Siegbahn; Marcus E Kleber; Alexander Dressel; Tanja B Grammer; Winfried März; Lars Wallentin Journal: J Am Coll Cardiol Date: 2017-08-15 Impact factor: 24.094
Authors: Saman Nazarian; David A Bluemke; Albert C Lardo; Menekhem M Zviman; Stanley P Watkins; Timm L Dickfeld; Glenn R Meininger; Ariel Roguin; Hugh Calkins; Gordon F Tomaselli; Robert G Weiss; Ronald D Berger; João A C Lima; Henry R Halperin Journal: Circulation Date: 2005-11-01 Impact factor: 29.690
Authors: Amit Noheria; Carmen Teodorescu; Audrey Uy-Evanado; Kyndaron Reinier; Ronald Mariani; Karen Gunson; Jonathan Jui; Sumeet S Chugh Journal: Int J Cardiol Date: 2013-05-17 Impact factor: 4.164
Authors: A Selcuk Adabag; Garry Peterson; Fred S Apple; Jack Titus; Richard King; Russell V Luepker Journal: Am Heart J Date: 2010-01 Impact factor: 4.749
Authors: Ankit Maheshwari; Faye L Norby; Elsayed Z Soliman; Selcuk Adabag; Eric A Whitsel; Alvaro Alonso; Lin Y Chen Journal: PLoS One Date: 2016-08-23 Impact factor: 3.240
Authors: Susan K Keen; Elham A Masoudi; Jefferson G Williams; Sanjana Thota-Kammili; Mojtaba Mirzaei; Feng-Chang Lin; Ross J Simpson Journal: Resusc Plus Date: 2021-01-29