Epidemiology of Sudden Cardiac Death: Clinical and Research Implications

Abstract

The current annual incidence of sudden cardiac death in the US is likely to be in the range of 180-250,000 per year. Coinciding with the decreased mortality from coronary artery disease, there is evidence pointing toward a significant decrease in rates of sudden cardiac death in the US during the second half of the twentieth century. However the alarming rise in prevalence of obesity and diabetes in the first decade of the new millennium both in the US and worldwide, would indicate that this favorable trend is unlikely to persist. We are likely to witness a resurgence of coronary artery disease and heart failure, as a result of which sudden cardiac death will have to be confronted as a shared and indiscriminate, worldwide public health problem. There is also increasing recognition of the fact that discovery of meaningful and relevant risk stratification and prevention methodologies will require careful prospective community-wide analyses, with access to large archives of DNA, serum and tissue that link with well-phenotyped databases. The purpose of this review is to summarize current knowledge of sudden cardiac death epidemiology. We will discuss the significance and strengths of community-wide evaluations of sudden cardiac death, summarize recent observations from such studies, and finally highlight specific potential predictors that warrant further evaluation as determinants of sudden cardiac death in the general population.

Vaccination and 30-Day Mortality Risk in Children, Adolescents, and Young Adults

“…Sudden deaths such as this, although uncommon, do occur in this population, regardless of vaccination history. [36][37][38] VAERS monitors the safety of all vaccinations, including 4vHPV. 39 From June 2006 to March 2013, 96 reports of death after receipt of 4vHPV vaccine were submitted to VAERS.…”

Evaluation of postmortem MDCT and MDCT-angiography for the investigation of sudden cardiac death related to atherosclerotic coronary artery disease

“…Atherosclerosis leading to ischemic heart disease is the most frequent cause of death in industrialized countries [1]. Ischemic heart disease, resulting from impaired cardiac blood supply, is mostly related to atherosclerotic coronary artery stenosis and can manifest as angina pectoris, acute myocardial infarction, chronic ischemic heart disease or sudden death.…”

Postmortem CT Angiography Compared with Autopsy: A Forensic Multicenter Study

“…The main reported weakness of postmortem CT, however, is relatively low soft-tissue contrast, especially in organ parenchyma, and poor ability to view the vascular system (8). Cardiovascular disease is a major cause of unexpected natural death in most developed countries (9), and this limitation decreases the potential of postmortem CT to help diagnose cardiovascular disease. Consequently, the reference standard for investigation of natural death, and particularly cardiovascular death, is considered to be conventional autopsy (2)(3)(4)(5)7).…”