High socioeconomic deprivation was independently associated with a 24% higher risk of incident sudden cardiac death compared to low deprivation (HR 1.24; 95% CI 1.11-1.37).
Cohort (n=500,877)
Does high socioeconomic deprivation increase the risk of incident sudden cardiac death and ventricular arrhythmias in adults without prior history of these conditions?
Socioeconomic deprivation is independently associated with an increased risk of sudden cardiac death and ventricular arrhythmias, emphasizing the importance of incorporating social determinants into risk assessment frameworks.
Hazard Ratio: 1.24 (95% CI 1.11–1.37)
p-value: p=<0.001
Abstract Background/Introduction Sudden cardiac death (SCD) accounts for a substantial proportion of cardiovascular mortality, yet its relationship with socioeconomic status remains underexplored in large population-based settings. Purpose To investigate the impact of socioeconomic deprivation on the risk of incident SCD and ventricular tachycardia/fibrillation (VT/VF) in a large prospective cohort. Methods We analyzed 500,877 UK Biobank participants without a prior history of SCD, ventricular arrhythmias, or implantable cardioverter-defibrillator insertion. Socioeconomic status was assessed using the Townsend Deprivation Index (TDI) and categorized into tertiles (low, middle, high). The primary outcome was incident SCD; the secondary outcome was incident VT/VF. Multivariable Cox proportional hazards models were applied to estimate associations, with sequential adjustment for demographic, lifestyle, and clinical comorbidities during a mean follow-up of 13.5 ± 2.1 years. Results The mean age was 56.5 ± 8.1 years, and 45.5% were men. During follow-up, 3,041 SCD events (incidence rate 0.45 per 1,000 person-years) and 2,203 VT/VF events occurred. A graded association was observed, with survival progressively lower across higher deprivation groups (log-rank P 0.001). In the fully adjusted model, compared to the low TDI group, the high TDI group had a 24% higher risk of SCD (HR: 1.24; 95% CI: 1.11-1.37) and an 18% higher risk of VT/VF (HR: 1.18; 95% CI: 1.05-1.34). Age-stratified analyses suggested overall deprivation was more pronounced among younger adults (≤50 years) with SCD, while income-related gradients were more prominent in older adults. A significant interaction was found with smoking (P-for-interaction=0.033), with the excess risk from deprivation markedly amplified among current smokers. Conclusion Socioeconomic deprivation, indexed by the TDI, was independently associated with an increased risk of SCD and VT/VF. These findings emphasize the importance of incorporating social determinants into SCD risk assessment frameworks and implementing targeted prevention strategies for disadvantaged populations.
Choi et al. (Mon,) conducted a cohort in Sudden cardiac death (n=500,877). High socioeconomic deprivation (Townsend Deprivation Index) vs. Low socioeconomic deprivation was evaluated on Incident sudden cardiac death (SCD) (HR 1.24, 95% CI 1.11-1.37, p=<0.001). High socioeconomic deprivation was independently associated with a 24% higher risk of incident sudden cardiac death compared to low deprivation (HR 1.24; 95% CI 1.11-1.37).
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