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Sudden cardiac death: epidemiology and risk factors

Nature Reviews Cardiology volume 7, pages 216–225 (2010)Cite this article

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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.

Key Points

  • Sudden cardiac death (SCD) is a common public health problem that causes more than 60% of all deaths from cardiovascular disease

  • Coronary heart disease underlies 80% of SCD cases; SCD is the first manifestation of heart disease in 50% of these individuals

  • Prospective surveillance programs, using multiple sources to identify cases of SCD, would enable more accurate determination of SCD burden in the community

  • Demographic, clinical, structural, laboratory, and genetic risk factors lack the specificity to identify individuals at high risk for SCD when used alone; multimarker SCD risk scores may improve SCD prediction

  • The risk of SCD after a coronary event changes with time, therefore, dynamic risk-profiling is important

  • Survival after sudden cardiac arrest is ∼5% and many individuals do not receive cardiopulmonary resuscitation or defibrillation; educating the public to use automated external defibrillators will be important to improving survival

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Figure 1
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.
Figure 3: Cumulative incidence of sudden cardiac death and all-cause mortality after myocardial infarction among residents of Olmsted County, MN, USA.
Figure 4: Distribution of clinical status of individuals who suffer sudden cardiac death.

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Acknowledgements

This work was funded in part by NIH grant number: NIH 5 R01 HL023727.

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Authors and Affiliations

  1. Division of Cardiology, Veterans Affairs Medical Center, One Veterans Drive, Minneapolis, 55417, MN, USA

    A. Selcuk Adabag

  2. Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, West Bank Office Building (WBOB), 1300 S. Second Street, Suite 300, Minneapolis, 55454-1015, MN, USA

    Russell V. Luepker

  3. Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, 55905, MN, USA

    Véronique L. Roger & Bernard J. Gersh

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  1. A. Selcuk Adabag
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  2. Russell V. Luepker
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Correspondence to A. Selcuk Adabag.

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Adabag, A., Luepker, R., Roger, V. et al. Sudden cardiac death: epidemiology and risk factors. Nat Rev Cardiol 7, 216–225 (2010). https://doi.org/10.1038/nrcardio.2010.3

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