What is the clinical evidence from this study?

Study design: Cohort. Population: Sudden cardiac arrest (n=1125691). Intervention: Sudden cardiac arrest. Primary outcome: Incidence of primary sudden cardiac arrest (per 100,000 person-years) (95% CI 15.4-16.8).

November 25, 2020PLoS ONEOpen Access

Incidence and etiology of sudden cardiac arrest in Koreans: A cohort from the national health insurance service database

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Key result

In a nationwide Korean cohort, the incidence of primary sudden cardiac arrest was 16.1 per 100,000 person-years, with coronary artery disease being the most common cause (59.4%) and sudden unexplained death syndrome accounting for 14.7% of cases.

Why the study?

The incidence of sudden cardiac arrest is lower in Asians than in Western populations, but data on its incidence and associated cardiac etiology in Asians are limited.

Study Design

Type

Cohort (n=1,125,691)

Structured PICO

Population

1,125,691 randomly selected South Korean subjects followed for 12 years to determine the incidence and etiology of sudden cardiac arrest and sudden unexplained death syndrome.

Outcome

Incidence and etiology of sudden cardiac arrest (SCA) and sudden unexplained death syndrome (SUDS)hard clinical

In a large Korean cohort, the incidence of primary sudden cardiac arrest was 16.1 per 100,000 person-years, with coronary artery disease being the most common cause and sudden unexplained death syndrome accounting for a significant 14.7% of cases.

Limitations

Possibility of misclassification of SCA cases due to reliance on death certificates and disease codes
Potential overestimation of SUDS rate among SCA cases because post-mortem autopsies are rarely performed
Lack of specific codes for inherited cardiac arrhythmias in the classification system used during the study period
Possibility of misclassification of SCA cases due to reliance on death certificates and disease/procedure codes
Possible overestimation of SUDS rate because post-mortem autopsies are rarely performed

Implication

Observational Korean data should not alter practice; extends SCA epidemiology to Asia while leaving generalizability and prevention open.

Abstract

The incidence of sudden cardiac arrest (SCA) in Asians is lower than that seen in Western populations, but there are few available data on the incidence and associated cardiac etiology of SCA in Asians. From 2002 to 2013, patients with SCA were analyzed using a cohort from the South Korean National Health Insurance Service (NHIS) coded database. Sudden unexplained death syndrome (SUDS) was defined as cryptogenic arrest, excluding that of non-cardiac origin, coronary artery disease (CAD), cardiomyopathy (CM), and valvular heart disease. During the 12-year study period, 5,973 patients (0.53%) from the total cohort of 1,125,691 had a cardiac arrest code. The overall incidence of arrest was 48.7 per 100,000 person-years (95% CI 16.6-18.0). The incidence of primary SCA excluding those of non-cardiac origin was 16.1 per 100,000 person-years (95% CI 15.4-16.8). It was higher in males than in females (18.1 vs. 14.1 per 100,000 person-years). CAD was the most common cause of SCA (59.4%), and followed by CM (13.9%). SUDS accounted for 14.7% of SCA events. The risk of SCA had increased gradually from over 25 years old. Heart failure, atrial fibrillation and hypertension are major factors associated with SCA incidence. Our findings outline epidemiologic data for SCA and the proportion of associated cardiac etiology leads SCA in a large population.

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Cite This Study

Roh et al. (2020) conducted a cohort in Sudden cardiac arrest (n=1,125,691). Sudden cardiac arrest was evaluated on Incidence of primary sudden cardiac arrest (per 100,000 person-years) (95% CI 15.4-16.8). In a nationwide Korean cohort, the incidence of primary sudden cardiac arrest was 16.1 per 100,000 person-years, with coronary artery disease being the most common cause (59.4%) and sudden unexplained death syndrome accounting for 14.7% of cases.

synapsesocial.com/papers/6a21f06700d082f62f96e143 https://doi.org/10.1371/journal.pone.0242799