Obesity in young sudden cardiac death: Rates, clinical features, and insights into people with body mass index >50kg/m²

Elizabeth D Paratz^{1

2

3}, Srikkumar Ashokkumar³, Alexander van Heusden¹, Karen Smith^{4

5}, Dominica Zentner^{6

7}, Natalie Morgan⁸, Sarah Parsons^{9

8}, Tina Thompson⁶, Paul James⁶, Vanessa Connell¹⁰, Andreas Pflaumer^{10

11

12}, Chris Semsarian¹³, Jodie Ingles¹⁴, Dion Stub^{1

2

4

9}, Andre La Gerche^{1

2

3}

Affiliations

¹ Baker Heart and Diabetes Institute, 75 Commercial Rd Prahran, Melbourne, VIC 3181, Australia.
² Alfred Hospital, 55 Commercial Rd Prahran, Melbourne, VIC 3181, Australia.
³ St Vincent's Hospital Melbourne, 41 Victoria Pde Fitzroy, Melbourne, VIC 3065, Australia.
⁴ Ambulance Victoria, 375 Manningham Rd, Doncaster, VIC 3108, Australia.
⁵ Department of Paramedicine, Monash University, Melbourne, VIC, Australia.
⁶ Royal Melbourne Hospital, 300 Grattan St, Parkville, VIC 3050, Australia.
⁷ Royal Melbourne Hospital Clinical School, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC 3000, Australia.
⁸ Victorian Institute of Forensic Medicine, 65 Kavanagh St, Southbank, VIC 3006, Australia.
⁹ Department of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, VIC 3004, Australia.
¹⁰ Royal Children's Hospital, 50 Flemington Rd Parkville Melbourne, VIC 3052, Australia.
¹¹ Department of Paediatrics, Melbourne University, Parkville, VIC 3010, Australia.
¹² Murdoch Children's Research Institute, Royal Children's Hospital, Flemington Rd, Parkville, VIC 3052, Australia.
¹³ Agnes Ginges Centre for Molecular Cardiology at Centenary Institute, The University of Sydney, Missenden Rd, Sydney, NSW 2050, Australia.
¹⁴ Garvan Institute of Medical Research, 384 Victoria St Darlinghurst, Sydney, NSW 2010, Australia.

PMID: 35928552
PMCID: PMC9344343
DOI: 10.1016/j.ajpc.2022.100369

Obesity in young sudden cardiac death: Rates, clinical features, and insights into people with body mass index >50kg/m²

Elizabeth D Paratz et al. Am J Prev Cardiol. 2022.

. 2022 Jul 26:11:100369.

doi: 10.1016/j.ajpc.2022.100369. eCollection 2022 Sep.

Authors

Affiliations

¹ Baker Heart and Diabetes Institute, 75 Commercial Rd Prahran, Melbourne, VIC 3181, Australia.
² Alfred Hospital, 55 Commercial Rd Prahran, Melbourne, VIC 3181, Australia.
³ St Vincent's Hospital Melbourne, 41 Victoria Pde Fitzroy, Melbourne, VIC 3065, Australia.
⁴ Ambulance Victoria, 375 Manningham Rd, Doncaster, VIC 3108, Australia.
⁵ Department of Paramedicine, Monash University, Melbourne, VIC, Australia.
⁶ Royal Melbourne Hospital, 300 Grattan St, Parkville, VIC 3050, Australia.
⁷ Royal Melbourne Hospital Clinical School, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC 3000, Australia.
⁸ Victorian Institute of Forensic Medicine, 65 Kavanagh St, Southbank, VIC 3006, Australia.
⁹ Department of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, VIC 3004, Australia.
¹⁰ Royal Children's Hospital, 50 Flemington Rd Parkville Melbourne, VIC 3052, Australia.
¹¹ Department of Paediatrics, Melbourne University, Parkville, VIC 3010, Australia.
¹² Murdoch Children's Research Institute, Royal Children's Hospital, Flemington Rd, Parkville, VIC 3052, Australia.
¹³ Agnes Ginges Centre for Molecular Cardiology at Centenary Institute, The University of Sydney, Missenden Rd, Sydney, NSW 2050, Australia.
¹⁴ Garvan Institute of Medical Research, 384 Victoria St Darlinghurst, Sydney, NSW 2010, Australia.

PMID: 35928552
PMCID: PMC9344343
DOI: 10.1016/j.ajpc.2022.100369

Abstract

Objective: To contextualize obesity rates in young sudden cardiac death (SCD) against the age-matched national population, and identify clinical and pathologic features in WHO class II and III obesity.

Methods: A prospective state-wide out-of-hospital cardiac arrest registry included all SCDs in Victoria, Australia from 2019-2021. Body mass indices (BMIs) of patients 18-50 years were compared to age-referenced general population. Characteristics of SCD patients with WHO Class II obesity (BMI ≥30kg/m²) and non-obesity (BMI<30kg/m²) were compared. Clinical characteristics of people with BMI>50kg/m² were assessed.

Results: 504 patients were included. Obesity was strongly over-represented in young SCD compared to the age-matched general population (55.0% vs 28.7%, p<0.0001). Obese SCD patients more frequently had hypertension, diabetes and obstructive sleep apnoea (p<0.0001, p=0.009 and p=0.001 respectively), ventricular fibrillation as their arrest rhythm (p=0.008) and left ventricular hypertrophy (LVH) (p<0.0001). Obese patients were less likely to have toxicology positive for illicit substances (22.0% vs 32.6%, p=0.008) or history of alcohol abuse (18.8% vs 26.9%, p=0.030). Patients with BMI>50 kg/m² represented 8.5% of young SCD. LVH (n=26, 60.5%) was their predominant cause of death and only 10 (9.3%) patients died from coronary disease.

Conclusion: Over half of young Australian SCD patients are obese, with all obesity classes over-represented compared to the general population. Obese patients had more cardiac risk factors. Almost two thirds of patients with BMI>50 kg/m² died from LVH, with fewer than 10% dying from coronary disease.

Keywords: BMI, body mass index; Cardiomyopathy; EndUCD, End Unexplained Cardiac Death Registry; Extreme obesity; OHCA, out of hospital cardiac arrest; Obesity; SCD, sudden cardiac death; Sudden cardiac death; VIFM, Victorian Institute of Forensic Medicine.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Image, graphical abstract — **Graphical abstract**

**Fig. 1**
CONSORT diagram indicating case inclusion criteria.

**Fig. 2**
Body mass index data of young SCD patients (red) contextualised against the general Australian population of the same age (blue).

**Fig. 3**
Causes of death according to body mass index

**Fig. 4**
Causes of death in patients with BMI>50kg/m².

See this image and copyright information in PMC

References

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Obesity in young sudden cardiac death: Rates, clinical features, and insights into people with body mass index >50kg/m²

Affiliations

Obesity in young sudden cardiac death: Rates, clinical features, and insights into people with body mass index >50kg/m²

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

LinkOut - more resources

Full Text Sources