Sudden cardiac versus non-cardiac death
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sara Zand, M.D.[2] Edzel Lorraine Co, DMD, MD[3] Nehal Eid, M.D.[4]
Overview
- Sudden cardiac death (SCD) is a natural, rapid, unexpected death secondary to cardiac causes within an hour of symptom onset in witnessed scenarios, and within a day in unwitnessed cases [1].
- The case definitions of sudden cardiac death in clinical registries or epidemiological research vary based on the use of death certificates,[2] [3] [4] [5] reviews of EMS[5] or hospital records[6],[7] [8][9][10] or whether the cases met the criteria of epidemiological definitions (eg, World Health Organization),[11]society definitions (eg, Cardiac Arrest Registry to EnhanceSurvival [CARES]),[12] outcomes of clinical trials,[13][14] or the definition required in pathology-based studies.[15][16][17] Because most individuals who died from sudden cardiac death do not have autopsies to confirm the underlying cause, sudden cardiac death is typically presumed to be of cardiac etiology.[18]
- Sudden cardiac arrest (SCA) is the unexpected cessation of pumping blood into vital organs due to electrical disturbance in the pathway of sinoatrial node (SA node), atrioventricular node (AV node), His Purkinje fibers or cardiac pumping failure due to cardiogenic shock, massive pulmonary thromboembolism,fulminant myocarditis, and ruptured left ventricular free wall.
- Out-of-hospital cardiac arrests are “events that occur out of the hospital in which an emergency medical services (EMS) rescuer detects no signs of circulation or mechanical cardiac activity.”[12][19]
- Without any intervention for immediate restoration of the circulation, biologic death will happen minutes to weeks after cardiac arrest. Sudden cardiac death in the United States ranges from 300,000 to 400,000 which is 50% of all causes of deaths. [20] In-hospital cardiac arrest happens in 290,000 adults every year in the United States. The most common cause of sudden cardiac death is coronary artery disease and atherosclerosis. The presence of underlying disorders such as malignancy or liver disease at the time of cardiac arrest makes the condition worse. Patients with acute myocardial infarction and in-hospital cardiac arrest with shockable rhythm have a better prognosis. Post cardiopulmonary resuscitation state management should be focused on neurologic complications, hemodynamic stability, and respiratory support.
| Source | Setting | Study years | Study type | Age range, y | Data source | No.of individuals | Autopsy rate, % | Toxicology | Incidence/100000 patient-years | Cardiac cause, % | SADSor SUD,% | Witnessed, % | During sleep,% | During exercise, % |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Out-of-hospital cardiac arrest | ||||||||||||||
| Kitamuraetal,[5] 2010 | Japan (Osaka) | 1998-2007 | Prospective | 13-49 | EMS records | 2220 | 0 | 3.8 | 22-32.1 | |||||
| Meyer et al,[9] 2012 | US (King County) | 1980-2009 | Retrospective | 25-35 | EMS and medical records, death certificates, autopsy reports | 361 | 72.9 | Overdoses excluded | 4.4 | 19.4 | 66.7 | 24.5 | ||
| Paratz et al,[21] 2022 | Australia (Victoria) | 2019-2021 | Prospective | 36-49 | Medical records, autopsy reports | 754 | 67.5 | Yes,positive in 17.1% (for ages 1-50y) | 30.2 | 55 | 10.9 | 28 | 41.2 | 9 |
| Empana et al,[22]2022 | Europe | 2012-2017 | Retrospective | 18-39 | Registry data | 0 | 14.4 (Men), 9.5 (Women) | |||||||
| Range | 3.8-30.2 | 55 | 10.9-19.4 | 28-66.7 | 41.2 | 9-24.5 | ||||||||
| Presumed sudden cardiac death | ||||||||||||||
| Hua et al,[23]2009 | China (4 regions) | 2005-2006 | Retrospective | 25-34 | Nationaldata,medical records,death certificates,autopsy reports | 284 | Rare | 7.8 | ||||||
| Hendrix et al,[24]2010 | The Netherlands (12 provinces) | 1996-2006 | Retrospective | 30-39 | Death certificates, forensic database | 1458 | 0 | 5.5(Men),2.4 (Women) | ||||||
| Margey et al,[25]2011 | Ireland | 2005-2007 | Retrospective | 15-35 | National data, autopsy reports | 292 | 70.5 | Yes,positive in 21.1% | 2.9 | 64 | 26.7 | 7.8 | ||
| van der Werf et al[26],2016 | The Netherlands (4 regions) | 2008-2011 | Retrospective | 1-44;Median, 38 (IQR,29-42) | EMS records, autopsy reports, general practitioners | 390 | 43 | Rarely, atcoroner’s discretion | 4.6 | 70 | 13.6 | 33 | 8 | |
| Bonny et al,[8] 2017 | Cameroon (Douala) | 2013 | Retrospective | 18-39 | EMS and medical records | Rare | 11.9 (Age range,18-29y) 42(Age range, 30-39y) | |||||||
| Tseng et al,[15] 2018 | US (San Francisco) | 2011-2014 | Prospective | 18-39 | EMS and medical records, forensic and autopsy reports | 32 | 97 | Yes,positivein 18.8% | 4.2 | 59 | 9 | 22 | 50 | 6 |
| Zhang et al,[10] 2019 | China (Xinjiang) | 2015 | Retrospective | 18-35 | Medical records, patient interview | Rare | 4.2 | |||||||
| Empana et al,[22] 2022 | Europe | 2012-2017 | Retrospective | 18-39 | Registry data | 0 | 6.7(Men)4.3 (Women) | |||||||
| Carrington et al,[27]2023 | Portugal (9 districts) | 2012-2016 | Retrospective | 1-40 Mean (SD):32 (7). | Medical records, forensic database | 159 | 100 | Yes,none positive | 2.4 | 58 | 32.1 | 17.5 | 15 | |
| Range (except Bonny et al [8]) | 2.4-7.8 | 40.7-67 | 9-32.1 | 22 | 17.5-50 | 6-15 | ||||||||
| Sudden cardiac death | ||||||||||||||
| Winkel
et al,[28]2011 |
Denmark | 2000-2006 | Retrospective | 1-35 Median (IQR),28 (21-33) | EMS and medical records, death certificates,autopsy reports, police reports | 469 | 75 | Done in 23.9% of SUDs, none positive | 1.9 | 29 | 45 | 34 | 11 | |
| Bagnall et al,[29] 2016 | Australia and New Zealand | 2010-2012 | Prospective | 21-35 | Medical records, death certificates, autopsy reports | 490 | 100 | Yes | 1.1-3.2 | 40 | 38 | 15 | ||
| Wisten et al,[30]2017 | Sweden | 2000-2010 | Retrospective | 18-35 | National data, medical records, death certificate | 552 | 95 | Positive toxicology cases excluded | 1.2-5.8 (Men), 0.5-2.2 (women) | 31 | 40 | 38 | 14 | |
| Tseng et al,[15]2018 | US (San Francisco County) | 2011-2014 | Prospective | 18-39 | EMS and medical records, forensic and autopsy reports | 19 | 97 | Yes,none positive | 2.4 | 18 | 37 | 39 | 21 | |
| Ha et al,[31] 2020 | Australia | 2000-2016 | Retrospective | 1-35 Mean (SD):28 (7) | Registry data, medical records, autopsy reports | 2006 | 95 | Done in 97%, positive toxicology cases excluded | 0.9-1.5 | 14 | 38 | 7 | ||
| Rücklová et al,[32]2022 | Czech Republic(5 regions) | 2014-2019 | Retrospective | 21-40 | Medical records, autopsy and police reports | 232 | 93 | Done in 51% | 3.4 | 11.8 | 27 | 38 | 7 | |
| Lynge et al,[33] 2023 | Denmark | 2002-2009 | Retrospective | 21-40 | Registry data, medical records, death certificates, autopsy reports | 620 | 55 | 2.7(Age,21-25y) 4.4(Age,26-30y) 6.5(Age,31-35y) 10.7(Age,36-40y) | 42 | 32 | 9 | |||
| Range | 0.5-10.7 | 11.8-40 | 27-45 | 32-39 | 7-21 | |||||||||
References
- ↑ Calvo Cuervo D (2023). “Comment on the ESC Guidelines 2022 for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death”. Eur Cardiol. 18: e01. doi:10.15420/ecr.2022.48. PMC 9947934 Check
|pmc=value (help). PMID 36844932 Check|pmid=value (help). - ↑ GillumRF.Sudden coronary death in the United States: 1980-1985. Circulation. 1989;79(4):756-765. doi:10.1161/01.CIR.79.4.756
- ↑ Escobedo LG, Zack MM. Comparison of sudden and nonsudden coronary deaths in the United States. Circulation. 1996;93(11):2033-2036. doi:10. 1161/01.CIR.93.11.2033
- ↑ Zheng ZJ, Croft JB, Giles WH, Mensah GA. Sudden cardiac death in the United States,1989 to 1998. Circulation. 2001;104(18):2158-2163. doi:10.1161/hc4301.098254
- ↑ 5.0 5.1 5.2 Kitamura T, Iwami T, Nichol G, et al; Utstein OsakaProject. Reduction in incidence and fatality of out-of-hospital cardiac arrest in females of the reproductive age. Eur Heart J. 2010;31(11):1365-1372. doi:10.1093/eurheartj/ehq059
- ↑ Escobedo LG,Zack MM.Comparison of sudden and nonsudden coronary deaths in the United States. Circulation. 1996;93(11):2033-2036. doi:10. 1161/01.CIR.93.11.2033
- ↑ Nichol G,Rumsfeld J,Eigel B,et al; American Heart Association Emergency Cardiovascular Care Committee;American Heart Association Council on Cardiopulmonary, Perioperative, and Critical Care; American Heart Association Council on Cardiovascular Nursing; American Heart Association Council on Clinical Cardiology; Quality of Care and Outcomes Research Interdisciplinary Working Group.Essential features of designating out-of-hospital cardiac arrest as a reportable event: a scientific statement from the American Heart Association Emergency Cardiovascular Care Committee;Council on Cardiopulmonary, Perioperative, and Critical Care; Council on Cardiovascular Nursing; Council on Clinical Cardiology; and Quality of Care and Outcomes ResearchInterdisciplinary Working Group. Circulation. 2008;117(17):2299-2308. doi:10.1161/ CIRCULATIONAHA.107.189472
- ↑ 8.0 8.1 8.2 Bonny A,Tibazarwa K,Mbouh S,et al; Pan African Society of Cardiology (PASCAR) Task Force on Sudden Cardiac Death.Epidemiology of sudden cardiac death in Cameroon:the first population-based cohort survey in sub-Saharan Africa. Int J Epidemiol. 2017;46(4):1230-1238. doi:10.1093/ije/dyx043
- ↑ 9.0 9.1 Meyer L,Stubbs B,Fahrenbruch C,et al. Incidence, causes, and survival trends from cardiovascular-related sudden cardiac arrest in children and young adults 0to35 years of age: a30-year review. Circulation. 2012;126(11):1363-1372. doi:10.1161/CIRCULATIONAHA.111.076810
- ↑ 10.0 10.1 Zhang J,Zhou X,Xing Q,et al.Epidemiological investigation of sudden cardiac death in multiethnic Xinjiang Uyghur autonomous region in Northwest China. BMC Public Health. 2019;19(1):116. doi:10. 1186/s12889-019-6435-8
- ↑ Sudden cardiac death.Report of a WHO scientific group. World Health Organ Tech Rep Ser. 1985;726:5-25.
- ↑ 12.0 12.1 McNally B, Stokes A, Crouch A, Kellermann AL, Group CS; CARESSurveillanceGroup. CARES: Cardiac Arrest Registry to Enhance Survival. Ann Emerg Med. 2009;54(5):674-683.e2.doi:10.1016/j. annemergmed.2009.03.018
- ↑ Chatterjee NA,Moorthy MV,Pester J,et al; PRE-DETERMINE Study Group.Sudden death in patients with coronary heart disease without severe systolic dysfunction. JAMA Cardiol. 2018;3 (7):591-600. doi:10.1001/jamacardio.2018.1049
- ↑ Olgin JE, Pletcher MJ, Vittinghoff E, et al; VEST Investigators. Wearable cardioverter-defibrillator after myocardial infarction. N Engl J Med. 2018;379 (13):1205-1215. doi:10.1056/NEJMoa1800781
- ↑ 15.0 15.1 15.2 Tseng ZH,Olgin JE,Vittinghoff E, et al. Prospective countywide surveillance and autopsy characterization of sudden cardiac death: POST SCD study.Circulation. 2018;137(25):2689-2700. doi:10.1161/CIRCULATIONAHA.117.033427
- ↑ Wu Q, Zhang L, Zheng J,et al.Forensic pathological study of 1656 cases of sudden cardiac death in southern China. Medicine (Baltimore). 2016;95(5):e2707. doi:10.1097/MD.0000000000002707
- ↑ Bagnall RD,Weintraub RG,Ingles J,et al. A prospective study of sudden cardiac death among children and young adults. NEnglJMed.2016;374 (25):2441-2452. doi:10.1056/NEJMoa1510687
- ↑ Marijon E,Narayanan K,Smith K,et al.The Lancet Commission to reduce the global burden of sudden cardiac death: a call for multidisciplinary action. Lancet. 2023;402(10405):883-936. doi:10.1016/S0140-6736(23)00875-9
- ↑ McNally B,Robb R,Mehta M,etal. Out-of-hospital cardiac arrest surveillance—Cardiac Arrest Registry to Enhance Survival (CARES), United States, October 1, 2005–December31, 2010. MMWRSurveillSumm.2011;60(8):1-19.
- ↑ Haissaguerre M, Hocini M, Sacher F, Shah A (2010). “[Sudden cardiac death, a major scientific challenge]”. Bull Acad Natl Med. 194 (6): 983–93, discussion 993-5. PMID 21513133.
- ↑ Paratz ED,van Heusden A, Zentner D,et al. Causes, circumstances, and potential preventability of cardiac arrest in the young: insights from a state-wide clinical and forensic registry. Europace. 2022;24(12):1933-1941. doi:10.1093/europace/ euac141
- ↑ 22.0 22.1 Empana JP, Lerner I, Valentin E, et al; ESCAPE-NET Investigators. Incidence of sudden cardiac death in the European Union.JAm Coll Cardiol. 2022;79(18):1818-1827. doi:10.1016/j.jacc. 2022.02.041
- ↑ Hua W, Zhang LF, Wu YF, et al.Incidence of sudden cardiac death in China:analysis of 4 regional populations. J Am Coll Cardiol. 2009;54 (12):1110-1118. doi:10.1016/j.jacc.2009.06.016
- ↑ Hendrix A, Vaartjes I, Mosterd A, et al. Regional differences in incidence of sudden cardiac death in the young.NethJMed.2010;68(6):274-279.
- ↑ Margey R, Roy A,Tobin S,et al.Sudden cardiac death in 14- to35-year olds in Ireland from 2005to 2007:a retrospective registry. Europace. 2011;13 (10):1411-1418. doi:10.1093/europace/eur161
- ↑ van der Werf C, Hendrix A, Birnie E, et al. Improving usual care after sudden death in the young with focus on inherited cardiac diseases (the CAREFULstudy):acommunity-based intervention study. Europace. 2016;18(4):592-601. doi:10.1093/europace/euv059
- ↑ Carrington M, de Gouveia RH, Teixeira R, Corte-Real F, Gonçalves L, Providência R. Sudden death in young South European population: across-sectional study of postmortem cases.SciRep. 2023;13(1):22734. doi:10.1038/s41598-023-47502-0
- ↑ Winkel BG, Holst AG, Theilade J,et al. Nationwide study of sudden cardiac death in persons aged1-35years. Eur HeartJ. 2011;32(8): 983-990.doi:10.1093/eurheartj/ehq428
- ↑ Bagnall RD, Weintraub RG, Ingles J, et al. A prospective study of sudden cardiac death among children and young adults. NEnglJMed.2016;374 (25):2441-2452. doi:10.1056/NEJMoa1510687
- ↑ Wisten A, Krantz P, Stattin EL. Sudden cardiac death among the young in Sweden from 2000 to 2010: an autopsy-based study.Europace.2017;19 (8):1327-1334.
- ↑ Ha FJ, Han HC, Sanders P, et al.Sudden cardiac death in the young: incidence, trends, and risk factors in a nationwide study. Circ Cardiovasc Qual Outcomes.2020;13(10):e006470.doi:10.1161/ CIRCOUTCOMES.119.006470
- ↑ Rücklová K, Dobiáš M, Bílek M, et al.Burden of sudden cardiac death in persons aged1-40 years in the CzechRepublic. CentEurJPublicHealth. 2022;30(1):58-64. doi:10.21101/cejph.a6793
- ↑ Lynge TH, Nielsen JL, Risgaard B, van der Werf C, Winkel BG,Tfelt-Hansen J. Causes of sudden cardiac death according to age and sex in persons aged 1-49years. HeartRhythm.2023;20(1):61-68. doi:10.1016/j.hrthm.2022.08.036
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