Clustering of risk factors including smoking, family history of SCD, and cardiac hypertrophy dramatically increased the odds of sudden cardiac death (OR 44.3; 95% CI 8.0-246.7).
Case-Control (n=1,069)
What risk factors differentiate victims of sudden cardiac death from survivors of an acute coronary event?
Clustering of specific risk factors, including family history of SCD, smoking, cardiac hypertrophy, and three-vessel CAD, strongly differentiates victims of sudden cardiac death from survivors of acute myocardial infarction.
Effect estimate: OR 44.3 (95% CI 8.0-246.7)
AIM: This study was designed to compare the risk profiles of sudden cardiac death (SCD) victims and survivors of an acute coronary event. METHOD: A case-control study included consecutive victims of SCD (n=425) verified to be due to an acute coronary event at medicolegal autopsy and consecutive patients surviving an acute myocardial infarction (AMI) (n=644). RESULTS: Family history of SCD (odds ratio (OR) 1.5, 95% confidence interval (CI) 1.0-2.2, P=0.03), male gender (OR 1.8, 95% CI 1.3-2.4, P<0.001), current smoking (OR 2.0, 95% CI 1.5-2.6, P<0.001), cardiac hypertrophy (OR 3.0, 95% CI 2.3-3.9, P<0.001) and three-vessel coronary artery disease (CAD) (OR 5.4, 95% CI 3.6-8.2, P<0.001) were more common among the victims of SCD as compared to survivors of AMI. There was a cumulative increase of risk of being a SCD victim versus AMI survivor when more than one risk factor was present, with the OR rising to 44.3 (95% CI 8.0-246.7) in a current male smoker with a family history of SCD and cardiac hypertrophy. CONCLUSIONS: There are specific features that differentiate the victims of SCD from survivors of an acute coronary event. Clustering of several variables, such as family history of SCD, smoking, cardiac hypertrophy and three-vessel CAD are alarm signals of a very high risk of SCD.
Kaikkonen et al. (Thu,) conducted a case-control in Acute coronary event (n=1,069). Risk factor clustering (family history, smoking, cardiac hypertrophy) vs. Survivors of acute myocardial infarction was evaluated on Sudden cardiac death (OR 44.3, 95% CI 8.0-246.7). Clustering of risk factors including smoking, family history of SCD, and cardiac hypertrophy dramatically increased the odds of sudden cardiac death (OR 44.3; 95% CI 8.0-246.7).