Distinctive profile of sudden cardiac arrest in middle-aged vs. older adults

A community-based study

Amit Noheria, Carmen Teodorescu, Audrey Uy-Evanado, Kyndaron Reinier, Ronald Mariani, Karen Gunson, Jonathan Jui, Sumeet S. Chugh

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Background While sudden cardiac arrest (SCA) rates increase with age, middle-aged adults (35-59 years) may comprise a significant proportion of SCA cases in the community (30-40%). However, there is a lack of studies evaluating SCA risk factors specifically associated with this age-group of the population. Methods Using prospective multiple-source surveillance methodology we identified cases of SCA ≥ 35 years in the ongoing Oregon Sudden Unexpected Death Study (Portland, Oregon metropolitan area, population ≈ 1,000,000). Out-of-hospital SCA cases, aged 35-59 years were compared to older SCA cases (≥ 60 years) in a comprehensive analysis of clinical profile of SCA. Results The middle-aged (n = 753) compared to older (n = 1251) cases were more likely to be male, obese, have sleep apnea and seizure disorder (all p ≤ 0.001); and were less likely to have a history of hypertension, diabetes mellitus, known coronary artery disease, congestive heart failure and syncope (all p <0.01). In multivariable analyses the middle-aged group had higher likelihood of male sex (O.R. 1.67, 95% C.I. 1.29-2.18), obesity (2.20, 1.52-3.19), sleep apnea (2.30, 1.44-3.68) and seizure disorder (2.69, 1.64-4.42); and lower rates of known coronary artery disease (0.57, 0.43-0.74) and congestive heart failure (0.35, 0.25-0.48). Conclusions SCA in the middle-aged adult was distinguishable from older subjects by higher rates of obesity, sleep apnea and seizure disorder; and lower prevalence of traditional clinical risk markers. With the growing epidemic of obesity, these findings have implications for SCA burden; and suggest the need for a clinical and investigational focus on SCA prediction and prevention in the middle-aged adult, that is distinct from older adults.

Original languageEnglish (US)
Pages (from-to)3495-3499
Number of pages5
JournalInternational Journal of Cardiology
Volume168
Issue number4
DOIs
StatePublished - Oct 9 2013

Fingerprint

Sudden Cardiac Death
Sleep Apnea Syndromes
Epilepsy
Obesity
Coronary Artery Disease
Heart Failure
Out-of-Hospital Cardiac Arrest
Syncope
Sudden Death
Population
Diabetes Mellitus
Age Groups
Biomarkers
Hypertension

Keywords

  • Community
  • Coronary artery disease
  • Middle-age
  • Obesity
  • Sudden-death

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Noheria, A., Teodorescu, C., Uy-Evanado, A., Reinier, K., Mariani, R., Gunson, K., ... Chugh, S. S. (2013). Distinctive profile of sudden cardiac arrest in middle-aged vs. older adults: A community-based study. International Journal of Cardiology, 168(4), 3495-3499. https://doi.org/10.1016/j.ijcard.2013.04.207

Distinctive profile of sudden cardiac arrest in middle-aged vs. older adults : A community-based study. / Noheria, Amit; Teodorescu, Carmen; Uy-Evanado, Audrey; Reinier, Kyndaron; Mariani, Ronald; Gunson, Karen; Jui, Jonathan; Chugh, Sumeet S.

In: International Journal of Cardiology, Vol. 168, No. 4, 09.10.2013, p. 3495-3499.

Research output: Contribution to journalArticle

Noheria, A, Teodorescu, C, Uy-Evanado, A, Reinier, K, Mariani, R, Gunson, K, Jui, J & Chugh, SS 2013, 'Distinctive profile of sudden cardiac arrest in middle-aged vs. older adults: A community-based study', International Journal of Cardiology, vol. 168, no. 4, pp. 3495-3499. https://doi.org/10.1016/j.ijcard.2013.04.207
Noheria, Amit ; Teodorescu, Carmen ; Uy-Evanado, Audrey ; Reinier, Kyndaron ; Mariani, Ronald ; Gunson, Karen ; Jui, Jonathan ; Chugh, Sumeet S. / Distinctive profile of sudden cardiac arrest in middle-aged vs. older adults : A community-based study. In: International Journal of Cardiology. 2013 ; Vol. 168, No. 4. pp. 3495-3499.
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abstract = "Background While sudden cardiac arrest (SCA) rates increase with age, middle-aged adults (35-59 years) may comprise a significant proportion of SCA cases in the community (30-40{\%}). However, there is a lack of studies evaluating SCA risk factors specifically associated with this age-group of the population. Methods Using prospective multiple-source surveillance methodology we identified cases of SCA ≥ 35 years in the ongoing Oregon Sudden Unexpected Death Study (Portland, Oregon metropolitan area, population ≈ 1,000,000). Out-of-hospital SCA cases, aged 35-59 years were compared to older SCA cases (≥ 60 years) in a comprehensive analysis of clinical profile of SCA. Results The middle-aged (n = 753) compared to older (n = 1251) cases were more likely to be male, obese, have sleep apnea and seizure disorder (all p ≤ 0.001); and were less likely to have a history of hypertension, diabetes mellitus, known coronary artery disease, congestive heart failure and syncope (all p <0.01). In multivariable analyses the middle-aged group had higher likelihood of male sex (O.R. 1.67, 95{\%} C.I. 1.29-2.18), obesity (2.20, 1.52-3.19), sleep apnea (2.30, 1.44-3.68) and seizure disorder (2.69, 1.64-4.42); and lower rates of known coronary artery disease (0.57, 0.43-0.74) and congestive heart failure (0.35, 0.25-0.48). Conclusions SCA in the middle-aged adult was distinguishable from older subjects by higher rates of obesity, sleep apnea and seizure disorder; and lower prevalence of traditional clinical risk markers. With the growing epidemic of obesity, these findings have implications for SCA burden; and suggest the need for a clinical and investigational focus on SCA prediction and prevention in the middle-aged adult, that is distinct from older adults.",
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AB - Background While sudden cardiac arrest (SCA) rates increase with age, middle-aged adults (35-59 years) may comprise a significant proportion of SCA cases in the community (30-40%). However, there is a lack of studies evaluating SCA risk factors specifically associated with this age-group of the population. Methods Using prospective multiple-source surveillance methodology we identified cases of SCA ≥ 35 years in the ongoing Oregon Sudden Unexpected Death Study (Portland, Oregon metropolitan area, population ≈ 1,000,000). Out-of-hospital SCA cases, aged 35-59 years were compared to older SCA cases (≥ 60 years) in a comprehensive analysis of clinical profile of SCA. Results The middle-aged (n = 753) compared to older (n = 1251) cases were more likely to be male, obese, have sleep apnea and seizure disorder (all p ≤ 0.001); and were less likely to have a history of hypertension, diabetes mellitus, known coronary artery disease, congestive heart failure and syncope (all p <0.01). In multivariable analyses the middle-aged group had higher likelihood of male sex (O.R. 1.67, 95% C.I. 1.29-2.18), obesity (2.20, 1.52-3.19), sleep apnea (2.30, 1.44-3.68) and seizure disorder (2.69, 1.64-4.42); and lower rates of known coronary artery disease (0.57, 0.43-0.74) and congestive heart failure (0.35, 0.25-0.48). Conclusions SCA in the middle-aged adult was distinguishable from older subjects by higher rates of obesity, sleep apnea and seizure disorder; and lower prevalence of traditional clinical risk markers. With the growing epidemic of obesity, these findings have implications for SCA burden; and suggest the need for a clinical and investigational focus on SCA prediction and prevention in the middle-aged adult, that is distinct from older adults.

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