Author + information
- Received November 22, 2010
- Revision received December 22, 2010
- Accepted January 31, 2011
- Published online September 13, 2011.
- Robert E. Eckart, DO⁎,⁎ (, )
- Eric A. Shry, MD†,
- Allen P. Burke, MD‡,
- Jennifer A. McNear, MD⁎,
- David A. Appel, MD⁎,
- Laudino M. Castillo-Rojas, MD⁎,
- Lena Avedissian, MD§,
- Lisa A. Pearse, MD‡,
- Robert N. Potter, MPH‡,
- Ladd Tremaine, MD‡,
- Philip J. Gentlesk, MD⁎,
- Linda Huffer, MD§,
- Stephen S. Reich, MD⁎,
- William G. Stevenson, MD∥,
- Department of Defense Cardiovascular Death Registry Group
- ↵⁎Reprint requests and correspondence:
LTC Robert E. Eckart, Cardiac Arrhythmia Service (Cardiovascular Division), Brooke Army Medical Center, 3851 Roger Brooke Drive, San Antonio, Texas 78234
Objectives The purpose of this study was to define the incidence and characterization of cardiovascular cause of sudden death in the young.
Background The epidemiology of sudden cardiac death (SCD) in young adults is based on small studies and uncontrolled observations. Identifying causes of sudden death in this population is important for guiding approaches to prevention.
Methods We performed a retrospective cohort study using demographic and autopsy data from the Department of Defense Cardiovascular Death Registry over a 10-year period comprising 15.2 million person-years of active surveillance.
Results We reviewed all nontraumatic sudden deaths in persons 18 years of age and over. We identified 902 subjects in whom the adjudicated cause of death was of potential cardiac etiology, with a mean age of 38 ± 11 years. The mortality rate for SCD per 100,000 person-years for the study period was 6.7 for males and 1.4 for females (p < 0.0001). Sudden death was attributed to a cardiac condition in 715 (79.3%) and was unexplained in 187 (20.7%). The incidence of sudden unexplained death (SUD) was 1.2 per 100,000 person-years for persons <35 years of age, and 2.0 per 100,000 person-years for those ≥35 years of age (p < 0.001). The incidence of fatal atherosclerotic coronary artery disease was 0.7 per 100,000 person-years for those <35 years of age, and 13.7 per 100,000 person-years for those ≥35 years of age (p < 0.001).
Conclusions Prevention of sudden death in the young adult should focus on evaluation for causes known to be associated with SUD (e.g., primary arrhythmia) among persons <35 years of age, with an emphasis on atherosclerotic coronary disease in those ≥35 years of age.
Dr. Appel is currently affiliated with Northwestern University, Chicago, Illinois. Dr. Avedissian is currently affiliated with Madigan Army Medical Center, Seattle, Washington. Dr. Pearse is currently affiliated with the Uniformed Services University, Bethesda, Maryland. Dr. Tremaine is currently affiliated with the Landstuhl Regional Medical Center, Landstuhl, Germany. Dr. Gentlesk is currently affiliated with Cardiology Consultants Ltd., Norfolk, Virginia. The opinions and research contained herein are the private ones of the authors and are not to be considered as official or reflecting the views of the Department of the Army or the Department of Defense. All authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received November 22, 2010.
- Revision received December 22, 2010.
- Accepted January 31, 2011.
- American College of Cardiology Foundation