In blacks, sudden coronary death with stable plaque was significantly associated with left ventricular hypertrophy (RR 7.6), type 1 diabetes (RR 3.6), and hypertension (RR 3.5).
Case-Control (n=1,025)
What are the traditional risk factors associated with sudden coronary death with and without coronary thrombosis in blacks?
Traditional risk factors such as left ventricular hypertrophy, diabetes, hypertension, and elevated cholesterol are strongly associated with sudden coronary death due to stable plaque in blacks, highlighting targets for reducing racial disparities in SCD.
Relative Risk: 7.6
BACKGROUND: Blacks have a high rate of sudden coronary death (SCD). We determined the rate of SCD in men and women 30 to 69 years of age in a 6-year period recorded at a state Medical Examiner's Office. METHODS AND RESULTS: In a subset of 327 whites and 130 blacks, hearts were systematically studied to determine the extent of coronary disease, presence and type of thrombus (acute rupture, acute erosion, stable plaque), and heart weight. These parameters were correlated with the presence of conventional risk factors. The estimated rate of SCD in blacks was similar to that in whites under the age of 40 years but increased compared with whites with advancing age, becoming 1.5 times the rate for whites in the 7th decade (95% of the increase in the 6th decade was due to sudden death with stable plaque). Among the autopsied group with severe coronary atherosclerosis, HDL cholesterol was higher and hypertension more prevalent in blacks, but there was no difference in the prevalence of healed infarcts, plaque burden, heart weight, acute thrombi, or rates of diabetes, cigarette smoking, and total cholesterol. CONCLUSIONS: When compared with a control autopsy group of 568 deaths, multivariate analysis showed a significant association in blacks between stable plaque and left ventricular hypertrophy (risk ratio, 7.6), type 1 diabetes (risk ratio, 3.6), hypertension (risk ratio, 3.5), elevated total cholesterol (risk ratio, 3.1) and type 2 diabetes (risk ratio, 2.9). Because these risk factors are associated with SCD in blacks, they may be important targets for reducing the disparately high rate of SCD in blacks as compared with whites.
Burke et al. (Tue,) conducted a case-control in Sudden coronary death (n=1,025). Traditional risk factors (e.g., left ventricular hypertrophy, diabetes, hypertension) vs. Control autopsy group was evaluated on Sudden coronary death with stable plaque (RR 7.6). In blacks, sudden coronary death with stable plaque was significantly associated with left ventricular hypertrophy (RR 7.6), type 1 diabetes (RR 3.6), and hypertension (RR 3.5).