Efforts to prevent sudden cardiac death in young adults ‘should be increased’
MedWire News: Factors linked to sudden unexplained death (SUD) should be assessed and atherosclerotic heart disease prevention should be extended in order to reduce the incidence of sudden cardiac death (SCD) in young adults, say US and German clinicians.
Although advances have been made in understanding the causes of sudden death and the ability to screen for genetic diseases and premature atherosclerosis, screening recommendations for young adults have remained unchanged for 4 decades.
Noting that military personnel represent an ideal opportunity to examine the cause-specific nature of sudden death, Robert Eckart, from Brooke Army Medical Center in San Antonio, Texas, USA, and colleagues studied demographic and autopsy data from the US Department of Defense Cardiovascular Death Registry, yielding 15.2 million person-years of active surveillance over 10 years.
There were 14,771 deaths between 1998 and 2008, from which 902 deaths with full records were available for review and for which the cause of death was of potential cardiac etiology.
The mortality rate for SCD per 100,000 person-years for the study period was 6.68 for males and 1.40 for females, which represented a highly significant difference. Sudden death was attributed to an identifiable structural cardiac finding in 79.3% of cases and was a SUD in 20.7%. The leading cause of death was SUD in individuals aged <35 years, at 41.3%, whereas it was atherosclerotic coronary artery disease in individuals aged ≥35 years, at 73.2%.
The incidence of death due to atherosclerotic coronary artery disease was 0.65 per 100,000 person-years for individuals <35 years of age, and 13.69 per 100,000 person-years for those ≥35 years of age. For SUD, the incidence was 1.2 per 100,000 person-years in personnel aged <35 years, and 2.0 per 100,000 person-years in those aged ≥35 years. In both cases, the difference was significant.
The researchers conclude in the Journal of the American College of Cardiology: "Because symptoms referable to cardiovascular disease were not commonly reported, lipid panels only demonstrated small variations from the mean, and the overall low risk profile of the patients experiencing events, consistent with that of prior studies; newer risk factors and advanced, safer imaging may be requisite before we can make an impact on identifying persons at risk for premature sudden death due to atherosclerosis."
MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010
By Liam Davenport