Joodi G, et al. J Gen Intern Med. 2019 Dec 5.
Joodi G, et al., conducted a study to evaluate the prevalence of CAD and its causative factors in 18–64-year-old adults in a population-related case log book of sudden deaths and its comparison to a living population from the same geographical area.
Of 1592 Emergency Medical Services (EMS) included out-of-hospital deaths, 399 were assisted as sudden death. Almost 371 (93%) those with details on their medical record, as well as from clinical histories no later than 5 years earlier to death or medical examiner’s report were included in this analysis. By randomly choosing participants from an electronic medical record repository of a major healthcare system in the area, comparison group was formed (n = 4218).
As compared to cases, living controls on average had 1 (SD 1.2) risk factor vs. 2.2 (SD 1.0) (Figure 1). Generally, 14.8% of sudden death subjects had history of CAD (16.5% in men, 11.1% in women) and 18.8% was highly common in older cases vs. 10.3% (Figure 2). As compared to cases without CAD, higher risk factors were observed in cases with CAD (Figure 3). As compared to living controls, cases showed maximum number of atherosclerotic risk factors in both age groups irrespective of CAD status. Most risk factors such as smoking, hypertension and dyslipidemia along with comorbidities such as DM, HF, and CKD were more common in older cases. As compared to older, obesity was highly prevalent in the younger cases (50% vs. 34.5%), and in both, young and old cases, diabetes was equally common (25% vs. 33%).
Thus, this study encourages the evolving attribution of sudden death. In the absence of clinically diagnosed CAD, utilization of newly imaging modalities and biomarkers may determine high-risk subjects and results in prevention of sudden death.
Figure 1: Average number of atherosclerotic cardiovascular disease risk factors in sudden death cases and living controls, among all subjects
Figure 2: Average number of atherosclerotic cardiovascular disease risk factors in sudden death cases and living controls, among those with history of CAD
Figure 3: Average number of atherosclerotic cardiovascular disease risk factors in sudden death cases and living controls, among those without history of CAD
