Sudden cardiac death: epidemiology and risk factors

Abstract

Sudden cardiac death (SCD) is an important public-health problem with multiple etiologies, risk factors, and changing temporal trends. Substantial progress has been made over the past few decades in identifying markers that confer increased SCD risk at the population level. However, the quest for predicting the high-risk individual who could be a candidate for an implantable cardioverter-defibrillator, or other therapy, continues. In this article, we review the incidence, temporal trends, and triggers of SCD, and its demographic, clinical, and genetic risk factors. We also discuss the available evidence supporting the use of public-access defibrillators.

Figure 1

Temporal trends in in-hospital and out-of-hospital cardiovascular mortality among men and women living in Minneapolis–St Paul, MN, USA.

Figure 2

Age distribution of sudden cardiac death among residents of Multnomah County, OR, USA (population 660,486) between 1 February 2002 and 31 January 2003. Reprinted from the Journal of the American College of Cardiology, 44(6), Chugh, S. S. et al. Current burden of sudden cardiac death: multiple source surveillance versus retrospective death certificate-based review in a large US community. 1268–1275 © 2004 with permission from Elsevier and the American College of Cardiology.

Figure 3

Cumulative incidence of sudden cardiac death and all-cause mortality after myocardial infarction among residents of Olmsted County, MN, USA. The shaded area represents the cumulative incidence of sudden cardiac death during the first 120 days after the index myocardial infarction. Reproduced from Adabag, A. S. et al. Sudden death after myocardial infarction. JAMA 5 November 2008; 300(17), 2022–2029. © 2008 American Medical Association. All rights reserved.

Figure 4

Distribution of clinical status of individuals who suffer sudden cardiac death. Abbreviations: AP, angina pectoris; MI, myocardial infarction; SCD, sudden cardiac death. Reprinted from Journal of the American College of Cardiology 54(9), Myerburg, R. J., Reddy, V. and Castellanos, A. Indications for implantable cardioverter-defibrillators based on evidence and judgment. 747–763. Copyright (2009), with permission from Elsevier and the American College of Cardiology.