Women Have a Lower Prevalence of Structural Heart Disease as a Precursor to Sudden Cardiac Arrest. The Ore-SUDS (Oregon Sudden Unexpected Death Study)

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

Research output: Contribution to journalArticle

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Abstract

Objectives: Our aim was to utilize a community-based approach to identify sex-related differences in risk factors for sudden cardiac arrest (SCA). Background: There are significant sex-based differences in prevalence and manifestation of SCA. Any differences related to predictors of SCA in women versus men are likely to have implications for risk stratification and prevention. Methods: The Ore-SUDS (Oregon Sudden Unexpected Death Study) is an ongoing prospective investigation of SCA in the Portland, Oregon, metropolitan area (population approximately 1 million). All cases meeting criteria for SCA were ascertained using multiple sources. Medical records were reviewed to identify clinical conditions that may contribute to SCA risk, and comparisons were made between male and female SCA cases using Pearson's chi-square tests for categorical variables, t tests for continuous variables, and multivariate logistic regression analysis. Results: During 2002 to 2007, 1,568 adult SCA cases were identified (women 36% vs. men 64%; p <0.0001) and women were older (mean age 71 ± 14 years vs. 65 ± 14 years, p <0.0001). There were no significant sex differences in prevalence of obesity, dyslipidemia, history of chronic obstructive pulmonary disease/asthma, left ventricular (LV) hypertrophy, or history of myocardial infarction. In multivariate analysis, women were significantly less likely to have severe LV dysfunction (odds ratio: 0.51; 95% confidence interval: 0.31 to 0.84) or previously recognized coronary artery disease (odds ratio: 0.34; 95% confidence interval: 0.20 to 0.60) compared with men. Conclusions: Women were significantly less likely than men to have a diagnosis of structural heart disease (LV dysfunction or coronary artery disease) before SCA. These findings suggest that fewer women may be eligible for prophylactic implantable cardioverter-defibrillator placement based on current guidelines and therefore may not have equal opportunity for prevention. Enhancement of SCA risk stratification may have even higher importance for women.

Original languageEnglish (US)
Pages (from-to)2006-2011
Number of pages6
JournalJournal of the American College of Cardiology
Volume54
Issue number22
DOIs
StatePublished - Nov 24 2009

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Sudden Cardiac Death
Sudden Death
Heart Diseases
Sex Characteristics
Left Ventricular Dysfunction
Coronary Artery Disease
Odds Ratio
Confidence Intervals
Implantable Defibrillators
Left Ventricular Hypertrophy
Chi-Square Distribution
Dyslipidemias
Chronic Obstructive Pulmonary Disease
Medical Records
Multivariate Analysis
Asthma
Obesity
Logistic Models
Myocardial Infarction
Regression Analysis

Keywords

  • coronary artery disease
  • death, sudden
  • ejection fraction
  • population
  • risk stratification
  • sex

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Women Have a Lower Prevalence of Structural Heart Disease as a Precursor to Sudden Cardiac Arrest. The Ore-SUDS (Oregon Sudden Unexpected Death Study). / Chugh, Sumeet S.; Uy-Evanado, Audrey; Teodorescu, Carmen; Reinier, Kyndaron; Mariani, Ronald; Gunson, Karen; Jui, Jonathan.

In: Journal of the American College of Cardiology, Vol. 54, No. 22, 24.11.2009, p. 2006-2011.

Research output: Contribution to journalArticle

Chugh, Sumeet S. ; Uy-Evanado, Audrey ; Teodorescu, Carmen ; Reinier, Kyndaron ; Mariani, Ronald ; Gunson, Karen ; Jui, Jonathan. / Women Have a Lower Prevalence of Structural Heart Disease as a Precursor to Sudden Cardiac Arrest. The Ore-SUDS (Oregon Sudden Unexpected Death Study). In: Journal of the American College of Cardiology. 2009 ; Vol. 54, No. 22. pp. 2006-2011.
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abstract = "Objectives: Our aim was to utilize a community-based approach to identify sex-related differences in risk factors for sudden cardiac arrest (SCA). Background: There are significant sex-based differences in prevalence and manifestation of SCA. Any differences related to predictors of SCA in women versus men are likely to have implications for risk stratification and prevention. Methods: The Ore-SUDS (Oregon Sudden Unexpected Death Study) is an ongoing prospective investigation of SCA in the Portland, Oregon, metropolitan area (population approximately 1 million). All cases meeting criteria for SCA were ascertained using multiple sources. Medical records were reviewed to identify clinical conditions that may contribute to SCA risk, and comparisons were made between male and female SCA cases using Pearson's chi-square tests for categorical variables, t tests for continuous variables, and multivariate logistic regression analysis. Results: During 2002 to 2007, 1,568 adult SCA cases were identified (women 36{\%} vs. men 64{\%}; p <0.0001) and women were older (mean age 71 ± 14 years vs. 65 ± 14 years, p <0.0001). There were no significant sex differences in prevalence of obesity, dyslipidemia, history of chronic obstructive pulmonary disease/asthma, left ventricular (LV) hypertrophy, or history of myocardial infarction. In multivariate analysis, women were significantly less likely to have severe LV dysfunction (odds ratio: 0.51; 95{\%} confidence interval: 0.31 to 0.84) or previously recognized coronary artery disease (odds ratio: 0.34; 95{\%} confidence interval: 0.20 to 0.60) compared with men. Conclusions: Women were significantly less likely than men to have a diagnosis of structural heart disease (LV dysfunction or coronary artery disease) before SCA. These findings suggest that fewer women may be eligible for prophylactic implantable cardioverter-defibrillator placement based on current guidelines and therefore may not have equal opportunity for prevention. Enhancement of SCA risk stratification may have even higher importance for women.",
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AU - Teodorescu, Carmen

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