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The burden of sudden cardiac death in terms of years of potential life lost is high compared with other leading causes of death in the U.S., researchers found.
Sudden cardiac death accounted for 41% to 50% of years of potential life lost due to heart disease, the leading cause of death for both men and women, according to Sumeet Chugh, MD, of the Cedars-Sinai Heart Institute in Los Angeles, and colleagues.
That impact was exceeded only by overall cancer and accidents among men and overall cancer for women, but was greater than for any individual cancer examined, they reported in the April issue of Circulation: Arrhythmia and Electrophysiology.
"The societal burden of sudden cardiac death is high relative to other major causes of death," the authors wrote. "Accordingly, improved national surveillance with the goal of optimizing and monitoring sudden cardiac death prevention and treatment should be a high priority."
"In areas where research collaborations between cardiology and emergency medicine systems are feasible, a network of nationally representative community-based studies of sudden cardiac death could be developed to measure rates and modes of cardiovascular death and track them over time," they continued. "Such an effort would facilitate a better understanding of sudden cardiac death causes and a more accurate and timely assessment of the effectiveness of ... prevention and treatment efforts."
A prior study estimated that sudden cardiac death accounted for 7% to 18% of all deaths in the U.S., but more detailed information about the burden of the problem has been hard to come by, with limited efforts to track it around the world, according to Chugh and colleagues.
In the current study, they examined death certificates, census data, and sudden cardiac death rates from the Oregon Sudden Unexpected Death Study (SUDS), a population-based surveillance study conducted in Multnomah County (which includes Portland).
After adjustment for age and sex, the estimated national rate of sudden cardiac death was 60 per 100,000 people. The figure was lower for women than for men (45 versus 76 per 100,000).
For men, the top causes of death were heart disease (including sudden cardiac death) and cancer, which occurred at rates of 205 and 197 per 100,000, respectively. Sudden cardiac death, by itself, ranked third, beating out the other leading causes of death examined, including lung cancer, accidents, chronic lower respiratory disease, cerebrovascular disease, diabetes, prostate cancer, and colorectal cancer.
Heart disease and cancer also topped the list of causes of death for women, occurring at rates of 188 and 174 per 100,000, respectively. The rate of sudden cardiac death (per 100,000) was similar to that of cerebrovascular disease (49), chronic lower respiratory disease (46), and lung cancer (45).
Sudden cardiac death was associated with 2.04 million years of potential life lost in men and 1.29 million years in women, representing 50% and 41%, respectively, of the years lost due to deaths from overall heart disease (4.11 million for men and 3.11 million for women).
When looking at noncardiovascular causes of death, the years of potential life lost were higher only for combined cancer (4.32 million) and accidental death (2.38 million) when compared with sudden cardiac death in men and only for combined cancer (4.47 million) in women.
"Creation of a nationwide surveillance system for cardiovascular disease has been recognized as a priority," Chugh and colleagues wrote. "As the present study illustrates, the high societal burden of sudden cardiac death alone could justify such a project."
Some limitations of the study included the use of information from a single metropolitan area to derive sudden cardiac death rates and the use of death certificate data, which might be inaccurate.
From the American Heart Association:
The study was funded by National Heart, Lung, and Blood Institute grants. Chugh holds the Pauline and Harold Price Endowed Chair in Cardiac Electrophysiology at the Cedars-Sinai Heart Institute.
Chugh disclosed no relevant relationships with industry. One of the other authors disclosed relevant relationships with Biotronik and Boston Scientific.
- Reviewed by F. Perry Wilson, MD, MSCE Instructor of Medicine, Perelman School of Medicine at the University of Pennsylvania
Circulation: Arrhythmia and ElectrophysiologySource Reference: Stecker E, et al "Public health burden of sudden cardiac death in the United States" Circ Arrhythm Electrophysiol 2014; 7: 212-217.