Key result
Women with sudden cardiac arrest have a ~4-fold higher rate of pulmonary embolism than men.
Why the study?
Sudden cardiac arrest in women remains understudied, often leading to generalized approaches without sex-specific clinical profiling and risk factor identification.
Observational (n=639)
Absolute Event Rate: 13.3% vs 3%
p-value: p=<0.001
Women experiencing sudden cardiac arrest have a distinct profile compared to men, characterized by a higher burden of pulmonary embolism and greater involvement of psychotropic drugs and toxic substances.
Higher PE frequency in women with SCA warrants diagnostic consideration; leaves open whether sex-specific protocols improve outcomes in prospective studies.
Background Sudden cardiac arrest (SCA) in women remains understudied, often leading to generalised approaches. We aimed to identify sex-specific differences in the clinical profile, risk factors, and causes of SCA to guide targeted interventions. Methods This prospective population-based study (ReCaPTa) analysed out-of-hospital cardiac arrests in a region of Spain (2014–2017). Data were triangulated from Emergency Medical Services, hospital records, and forensic autopsies. SCA was defined as an unexpected cardiac arrest, with a presumed cardiac cause, occurring within 1 hour of symptom onset or seen to be alive and well within the last 24 hours. Results Of 639 SCA cases, 191 (29.9%) were women. Compared with men, women were older (74 vs 66 years, p < 0.001), had more morning SCA and had a higher prevalence of previous psychiatric disorders (15.6% vs 9.0%, p = 0.03) and alcohol abuse (25.4% vs 16.1%, p = 0.01). Toxicological analysis showed significantly higher antidepressant positivity in women (11.3% vs 1.8%, p = 0.004). Women had fewer shockable rhythms (21% vs 36%, p = 0.01), fewer resuscitation attempts, and lower survival rates (4.2% vs 9.9%, p = 0.01). While acute coronary disease was the leading cause in women (20.0%), they exhibited a distinct non-ischaemic profile: pulmonary embolism (PE) was more frequent than in men (13.3% vs 3.0%, p < 0.001) and was universally fatal (0% survival). Conclusion Compared with men, women with SCA exhibited a disproportionately higher burden of PE and a greater involvement of psychotropic drugs and toxic substances.
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Azeli et al. (2026) conducted an observational in Sudden cardiac arrest (n=639). Female sex vs. Male sex was evaluated on Pulmonary embolism as the cause of sudden cardiac arrest (p=<0.001). Compared to men, women with sudden cardiac arrest exhibited a significantly higher frequency of pulmonary embolism (13.3% vs 3.0%, p < 0.001) and a distinct non-ischemic profile.
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