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(Circulation. 2001;104:2158.)
© 2001 American Heart Association, Inc.
Clinical Investigation and Reports |
From the Cardiovascular Health Branch, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Ga.
Correspondence to Dr Zhi-Jie Zheng, Cardiovascular Health Branch, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Mailstop K-47, Atlanta, GA 30341-3717. E-mail zzheng{at}cdc.gov
| Abstract |
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Methods and Results United States (US) vital statistics mortality data from 1989 to 1998 were analyzed. SCD is defined as deaths occurring out of the hospital or in the emergency room or as "dead on arrival" with an underlying cause of death reported as a cardiac disease (ICD-9 code 390 to 398, 402, or 404 to 429). Death rates were calculated for residents of the US aged
35 years and standardized to the 2000 US population. Of 719 456 cardiac deaths among adults aged
35 years in 1998, 456 076 (63%) were defined as SCD. Among decedents aged 35 to 44 years, 74% of cardiac deaths were SCD. Of all SCDs in 1998, coronary heart disease (ICD-9 codes 410 to 414) was the underlying cause on 62% of death certificates. Death rates for SCD increased with age and were higher in men than women, although there was no difference at age
85 years. The black population had higher death rates for SCD than white, American Indian/Alaska Native, or Asian/Pacific Islander populations. The Hispanic population had lower death rates for SCD than the non-Hispanic population. From 1989 to 1998, SCD, as the proportion of all cardiac deaths, increased 12.4% (56.3% to 63.9%), and age-adjusted SCD rates declined 11.7% in men and 5.8% in women. During the same time, age-specific death rates for SCD increased 21% among women aged 35 to 44 years.
Conclusions SCD remains an important public health problem in the US. The increase in death rates for SCD among younger women warrants additional investigation.
Key Words: death, sudden heart diseases mortality epidemiology
| Introduction |
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Clinically, SCD is the sudden, unexpected natural death from a cardiac cause a short time (generally
1 hour) after the onset of symptoms in a person without any previous condition that would seem fatal.5,6 Unfortunately, such a definition is difficult to apply in the public health surveillance, because the death certificate often does not include the time of onset. As an alternative, Gillum and colleagues1012 have defined SCD as any cardiac death occurring out of the hospital or taking place in the emergency room or dead on arrival in the emergency room. This approach has reasonable validity13,14 and is useful for assessing population trends in SCD. The present study uses a similar approach with some modifications to characterize the epidemiologic features of SCD in residents of the United States (US) aged
35 years and to describe the secular trend of SCD from 1989 to 1998.
| Methods |
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All analyses were performed using SAS and were limited to US residents aged
35 years because of the small number of younger cases (<1%). We also limited our analyses for 1989 and later because of the major change in the coding of place of death in death certificates in 1989. We assessed characteristics and trends in the proportions of cardiac deaths that were SCD, characteristics of persons suffering SCD in 1998, and trends in death rates for SCD from 1989 to 1998. Death rates for SCD were calculated for groups defined by calendar year, age (35 to 44, 45 to 54, 55 to 64, 65 to 74, 75 to 84, and
85 years), sex, and race (white, black, American Indian/Alaska Native, and Asian/Pacific Islander). Hispanic origin has been reported on death certificates since 1978; since then, an increasing number of states have added this item. Because of large missing data in earlier years, the variable was used in 1998 analyses only. Denominators were the US Bureau of the Census mid-year estimates of the resident population for each group.16 Age-adjusted death rates were standardized by the direct method to the 2000 projected US population.17 Relative change in death rates for SCD from 1989 to 1998 was calculated as the 1998 rate minus the 1989 rate, divided by the 1989 rate, and multiplied by 100.
| Results |
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35 years, of which 456 076 (63.3%) were defined as SCD. The proportion of SCD among all cardiac deaths in 1998 did not differ substantially between men (62.9%) and women (63.8%). However, women had higher proportion of out-of-hospital cardiac deaths than men, whereas men had higher proportion of death occurring in the emergency room or as "dead on arrival" (Table 1). For younger ages (35 to 74 years), SCD as the proportion of all cardiac death was higher in men (66.6%) than women (57.2%). Overall, SCDs accounted for 74.4% of all cardiac disease deaths for ages 35 to 44 years; 72.7% for 45 to 54 years; 65.6% for 55 to 64 years; 58.0% for 65 to 74 years; 58% for 75 to 84 years; and 68.8% for
85 years. In 1998, the proportions of cardiac deaths that occurred in hospital or out of hospital were generally higher for successive age groups; conversely, the proportion that occurred in the emergency room or were dead on arrival generally declined with age (Table 1).
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SCD accounted for 63.7% of all cardiac deaths among whites; 62.0% among blacks; 60.5% among American Indians/Alaska Natives; and 55.2% among Asian/Pacific Islanders. The proportion of cardiac deaths that were SCD was higher among non-Hispanics than Hispanics (63.7% versus 54.5%). Whites had a greater proportion of cardiac deaths out of hospital than other groups, whereas blacks had the highest proportion of cardiac deaths occurring in the emergency room or as "dead on arrival" (Table 1).
SCD as the proportion of all cardiac deaths increased 12.4% from 1989 to 1998 (56.3% to 63.9%). The proportion of cardiac deaths that occurred in the emergency room or as "dead on arrival" decreased 9.7%, and the proportion of out-of-hospital SCD increased 23.5% (Table 1).
Of the 456 076 persons suffering SCD in 1998, 51.6% were women and 82.8% were aged
65 years. The mean age of SCD victims was 70 years in men and 82.4 years in women. In 1998, coronary heart disease (ICD-9 410 to 414) was listed as the underlying cause on 62.2% of the death certificates. The distribution of underlying causes of death for SCD decedents varied between those aged 35 to 64 years and those aged
65 years (Table 2). Acute ischemic heart disease (ICD-9 410 to 411), unspecified cardiovascular disease (ICD-9 429.2), and cardiomyopathy and dysrhythmias (ICD-9 425 to 427) were more common in the younger group. Chronic ischemic heart disease (ICD-9 412 to 414) and heart failure (ICD-9 428) were more frequent in the older group.
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As expected, age-specific death rates for SCD in 1998 increased with successive age groups and were higher in men (Table 3), although the gender difference narrowed in older groups and disappeared for ages
85 years. The male to female ratio was 2.9 at 35 to 44 years; 3.4 at 45 to 54 years; 2.8 at 55 to 64 years; 2.1 at 65 to 74 years; 1.5 at 75 to 84 years; and 1 at
85 years. The overall age-adjusted death rate for SCD was 50% higher in men than women (410.6 versus 274.6 per 100 000) in 1998. The black population had the highest age-adjusted rates, followed by white, American Indians/Alaska Native, and Asian/Pacific Islander populations (Table 3). Non-Hispanic adults had higher age-adjusted rates for SCD than did Hispanic adults.
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Although SCD rates declined between 1989 and 1998 among men in all age groups, they increased 21.1% among women aged 35 to 44 years (Table 3). Overall, age-adjusted SCD rates declined 8.3% (11.7% in men and 5.8% in women) during this 10-year period. This decline was observed in all race groups among men (Figure 1) and in all but American Indian/Alaska Native women, who experienced declining SCD rates until 1996, with an increase in SCD rate in 1997 and 1998 (Figure 2).
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| Discussion |
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We found disturbing trends for women in this report: >50% of their cardiac deaths were out of hospital; their decline in SCD rates was much less than it was for men, and the rate for SCD increased 21% among women aged 35 to 44 years. The reasons for such disturbing trends are not known, and, thus, additional investigation is warranted. A variety of differences in awareness, risk factors, underlying etiology, symptoms and signs, and outcomes of cardiovascular disease may have played some roles. For example, in a recent study, >70% of women reported that they did not talk to their doctors about heart disease, and <10% considered it to be their greatest health concern.18 Women may receive less aggressive and more delayed treatment for heart disease than men,19,20 and they usually have a higher risk of death after heart attack, particularly young women.20,21 Furthermore, because the symptoms of heart disease in women are often atypical (eg, neck pain, back pain, jaw pain, or nausea) of chest pain, they may go unrecognized.22 In addition, reports have indicated that the risk factors for and pathophysiology of SCD may differ in younger versus older women. For example, younger women with SCD were more likely to be smokers, whereas older women had higher prevalence of hypercholesterolemia, hypertension, and diabetes2326; plaque erosion leading to acute coronary thrombosis is more common in younger women with SCD, whereas plaque rupture or healed myocardial infarction without acute coronary thrombosis was the dominant lesion among older women.23
Surveillance reports using death certificate data have several limitations. First, the cause of death is not validated by a medical record or autopsy verification. The reliability and accuracy of cause of death depends on the correctness of the diagnosis and accuracy with which the death certificate is completed by the physician, medical examiner, or coroner. A previous study indicated that coronary heart disease may be substantially over-represented as a cause of death on death certificates, with the consequence that national mortality statistics may have overestimated the frequency of coronary heart disease by up to 24%.27 Second, the consensus clinical definition of SCD in the US includes death within 1 hour of onset of symptoms as a major criterion,2,3,57,2426 although other criteria, such as death within 6 hours and 24 hours, were also used in other studies.28 Unfortunately, time of onset of disease symptoms and time of death are often not recorded on death certificates. However, studies involving retrospective physician review have reported that the validity of the underlying cause of death on the death certificate for out-of-hospital coronary heart disease deaths and SCD is high.13,14,29 Despite the potential of either misdiagnosis or misreporting of diagnosis, death certificate data remain useful and the only data source presently available to assess population and national trends in SCD, provided that the false-positive rate remains relatively constant over time. Ultimately, an improved national surveillance system or a national registry on SCD will be essential in providing better information on incidence, management, and outcomes and will help determine the success of clinical and public health interventions against cardiovascular disease in the population.
The validity of the reporting of race and Hispanic ethnicity on death certificates is another concern. To our knowledge, few studies have examined SCD in American Indian/Alaskan Native, Asian/Pacific Islander, or Hispanic populations in the US. In this report, we found that adults in these racial and ethnic groups had lower SCD death rates than white or black adults. Underreporting of American Indian/Alaska Native or Asian/Pacific Islander race or of Hispanic ethnicity on death certificates and census population counts may lead to underestimates of SCD in these groups and overestimates among white and black populations.3032 In addition, another limitation of surveillance report based on death certificate data is that we are unable to ascertain predisposing risk factors for SCDs other than age, race, ethnicity, and sex.
These limitations notwithstanding, this surveillance report is valuable for its provision of the most recently available statistics for SCD for the entire US adult population. Unlike case-control studies and hospital registries, the US death certificate data has sufficient numbers to allow comparisons of secular trends, sex, age, and race or ethnicity. In addition, this study differs from the previous reports that focused on sudden death attributable to coronary heart disease only2,3,1012,26 by including all cardiac disease, which may yield a more in-depth understanding of the etiology of sudden cardiac death in the US population.
The encouraging declines in the proportion of cardiac deaths occurring in the hospital or the emergency room or as "dead on arrival" may reflect the improvements in emergency services and more timely and appropriate treatment. However, the increased trend in SCD outside of the hospital indicates a need for public health initiatives to improve the early recognition of heart attack symptoms and signs. Educational and media efforts should specifically target women and younger adults, who may dismiss cardiac arrest as a problem of men and the elderly. According to the Rapid Early Action for Coronary Treatment Trial, although knowledge of chest pain as an important heart attack symptom is relatively high in the US, there are racial and gender variations in identifying correct symptoms and signs of heart disease.33 National efforts are needed to increase the proportion of the general public who recognize signs and symptoms of a heart attack and who are willing to participate in the "chain of survival," which includes dialing 911, attempting cardiac resuscitation, and using automated external defibrillators until emergency personnel arrive.34 Finally, the primary prevention of coronary heart disease should remain a major focus of public health. Physicians and other health care providers should never miss the opportunity during routine physical examinations to counsel patients, including apparently healthy young adults and women of all ages, about the importance of controlling high blood pressure and high cholesterol levels, smoking avoidance or cessation, weight management, regular physical activity, and a diet low in saturated fats and cholesterol and rich in fruits and vegetables.
In conclusion, SCD remains an important clinical and public health problem in the US. Increased death rates for SCD among younger women warrant additional investigation of their potential risk factors. Public health education and media efforts should target increased awareness of the symptoms and signs of cardiac arrest and should attempt to increase the numbers of bystanders trained and willing to initiate the "chain of survival."
Received June 25, 2001; accepted August 20, 2001.
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A. Breitenstein, S.F. Stampfli, G.G. Camici, A. Akhmedov, H.R. Ha, F. Follath, A. Bogdanova, T.F. Luscher, and F.C. Tanner Amiodarone Inhibits Arterial Thrombus Formation and Tissue Factor Translation Arterioscler Thromb Vasc Biol, December 1, 2008; 28(12): 2231 - 2238. [Abstract] [Full Text] [PDF] |
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P. A. Noseworthy and C. Newton-Cheh Genetic Determinants of Sudden Cardiac Death Circulation, October 28, 2008; 118(18): 1854 - 1863. [Full Text] [PDF] |
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R. Rosso, E. Kogan, B. Belhassen, U. Rozovski, M. M. Scheinman, D. Zeltser, A. Halkin, A. Steinvil, K. Heller, M. Glikson, et al. J-Point Elevation in Survivors of Primary Ventricular Fibrillation and Matched Control Subjects: Incidence and Clinical Significance J. Am. Coll. Cardiol., October 7, 2008; 52(15): 1231 - 1238. [Abstract] [Full Text] [PDF] |
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J. K. Triedman Should patients with congenital heart disease and a systemic ventricular ejection fraction less than 30% undergo prophylactic implantation of an ICD?: Implantable Cardioverter Defibrillator Implantation Guidelines Based Solely on Left Ventricular Ejection Fraction Do Not Apply to Adults With Congenital Heart Disease Circ Arrhythm Electrophysiol, October 1, 2008; 1(4): 307 - 316. [Full Text] [PDF] |
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Council on School Health Medical Emergencies Occurring at School Pediatrics, October 1, 2008; 122(4): 887 - 894. [Abstract] [Full Text] [PDF] |
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L. Ding, W. Hua, H. Niu, K. Chen, and S. Zhang Primary prevention of sudden cardiac death using implantable cardioverter defibrillators Europace, September 1, 2008; 10(9): 1034 - 1041. [Abstract] [Full Text] [PDF] |
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C. A. Herzog, J. W. Strief, A. J. Collins, and D. T. Gilbertson Cause-specific mortality of dialysis patients after coronary revascularization: why don't dialysis patients have better survival after coronary intervention? Nephrol. Dial. Transplant., August 1, 2008; 23(8): 2629 - 2633. [Abstract] [Full Text] [PDF] |
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J. Hollenberg, J. Herlitz, J. Lindqvist, G. Riva, K. Bohm, M. Rosenqvist, and L. Svensson Improved Survival After Out-of-Hospital Cardiac Arrest Is Associated With an Increase in Proportion of Emergency Crew-Witnessed Cases and Bystander Cardiopulmonary Resuscitation Circulation, July 22, 2008; 118(4): 389 - 396. [Abstract] [Full Text] [PDF] |
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W. S Harris The omega-3 index as a risk factor for coronary heart disease Am. J. Clinical Nutrition, June 1, 2008; 87(6): 1997S - 2002S. [Abstract] [Full Text] [PDF] |
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R. Byrne, O. Constant, Y. Smyth, G. Callagy, P. Nash, K. Daly, and J. Crowley Multiple source surveillance incidence and aetiology of out-of-hospital sudden cardiac death in a rural population in the West of Ireland Eur. Heart J., June 1, 2008; 29(11): 1418 - 1423. [Abstract] [Full Text] [PDF] |
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R. Deo, F. Lin, E. Vittinghoff, Z. H. Tseng, S. B. Hulley, and M. G. Shlipak Kidney Dysfunction and Sudden Cardiac Death Among Women With Coronary Heart Disease Hypertension, June 1, 2008; 51(6): 1578 - 1582. [Abstract] [Full Text] [PDF] |
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V. L. Vetter, J. Elia, C. Erickson, S. Berger, N. Blum, K. Uzark, and C. L. Webb Cardiovascular Monitoring of Children and Adolescents With Heart Disease Receiving Medications for Attention Deficit/Hyperactivity Disorder: A Scientific Statement From the American Heart Association Council on Cardiovascular Disease in the Young Congenital Cardiac Defects Committee and the Council on Cardiovascular Nursing Circulation, May 6, 2008; 117(18): 2407 - 2423. [Full Text] [PDF] |
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D. L. Carroll and G. A. Hamilton Long-term Effects of Implanted Cardioverter-Defibrillators on Health Status, Quality of Life, and Psychological State Am. J. Crit. Care., May 1, 2008; 17(3): 222 - 230. [Abstract] [Full Text] [PDF] |
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G. Nichol, J. Rumsfeld, B. Eigel, B. S. Abella, D. Labarthe, Y. Hong, R. E. O'Connor, V. N. Mosesso, R. A. Berg, B. B. Leeper, et al. Essential Features of Designating Out-of-Hospital Cardiac Arrest as a Reportable Event: A Scientific Statement From the American Heart Association Emergency Cardiovascular Care Committee; Council on Cardiopulmonary, Perioperative, and Critical Care; Council on Cardiovascular Nursing; Council on Clinical Cardiology; and Quality of Care and Outcomes Research Interdisciplinary Working Group Circulation, April 29, 2008; 117(17): 2299 - 2308. [Abstract] [Full Text] [PDF] |
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B. J. Bobrow, L. L. Clark, G. A. Ewy, V. Chikani, A. B. Sanders, R. A. Berg, P. B. Richman, and K. B. Kern Minimally Interrupted Cardiac Resuscitation by Emergency Medical Services for Out-of-Hospital Cardiac Arrest JAMA, March 12, 2008; 299(10): 1158 - 1165. [Abstract] [Full Text] [PDF] |
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M. de Lorgeril, P. Salen, T. Corcos, P. Defaye, M. Juneau, B. Pavy, and N. Saoudi Is moderate drinking as effective as cholesterol lowering in reducing mortality in high-risk coronary patients? Eur. Heart J., January 1, 2008; 29(1): 4 - 6. [Full Text] [PDF] |
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C. M. Albert, E. G. Nam, E. B. Rimm, H. W. Jin, R. J. Hajjar, D. J. Hunter, C. A. MacRae, and P. T. Ellinor Cardiac Sodium Channel Gene Variants and Sudden Cardiac Death in Women Circulation, January 1, 2008; 117(1): 16 - 23. [Abstract] [Full Text] [PDF] |
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S. M. Narayan, M. R. Franz, G. Lalani, J. Kim, and A. Sastry T-Wave Alternans, Restitution of Human Action Potential Duration, and Outcome J. Am. Coll. Cardiol., December 18, 2007; 50(25): 2385 - 2392. [Abstract] [Full Text] [PDF] |
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G. Boriani, R. Ricci, T. Toselli, R. Ferrari, A. Branzi, and M. Santini Implantable cardioverter defibrillators: from evidence of trials to clinical practice Eur. Heart J. Suppl., December 1, 2007; 9(suppl_I): I66 - I73. [Abstract] [Full Text] [PDF] |
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H. Halperin, N. Paradis, V. Mosesso Jr, G. Nichol, M. Sayre, J. P. Ornato, M. Gerardi, V. M. Nadkarni, R. Berg, L. Becker, et al. Recommendations for Implementation of Community Consultation and Public Disclosure Under the Food and Drug Administration's "Exception From Informed Consent Requirements for Emergency Research": A Special Report From the American Heart Association Emergency Cardiovascular Care Committee and Council on Cardiopulmonary, Perioperative and Critical Care: Endorsed by the American College of Emergency Physicians and the Society for Academic Emergency Medicine Circulation, October 16, 2007; 116(16): 1855 - 1863. [Full Text] [PDF] |
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L. H. Curtis, S. M. Al-Khatib, A. M. Shea, B. G. Hammill, A. F. Hernandez, and K. A. Schulman Sex Differences in the Use of Implantable Cardioverter-Defibrillators for Primary and Secondary Prevention of Sudden Cardiac Death JAMA, October 3, 2007; 298(13): 1517 - 1524. [Abstract] [Full Text] [PDF] |
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A. F. Hernandez, G. C. Fonarow, L. Liang, S. M. Al-Khatib, L. H. Curtis, K. A. LaBresh, C. W. Yancy, N. M. Albert, and E. D. Peterson Sex and Racial Differences in the Use of Implantable Cardioverter-Defibrillators Among Patients Hospitalized With Heart Failure JAMA, October 3, 2007; 298(13): 1525 - 1532. [Abstract] [Full Text] [PDF] |
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W. H Ibrahim Recent advances and controversies in adult cardiopulmonary resuscitation Postgrad. Med. J., October 1, 2007; 83(984): 649 - 654. [Abstract] [Full Text] [PDF] |
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A. E. Buxton, K. L. Lee, G. E. Hafley, L. A. Pires, J. D. Fisher, M. R. Gold, M. E. Josephson, M. H. Lehmann, E. N. Prystowsky, and for the MUSTT Investigators Limitations of Ejection Fraction for Prediction of Sudden Death Risk in Patients With Coronary Artery Disease: Lessons From the MUSTT Study J. Am. Coll. Cardiol., September 18, 2007; 50(12): 1150 - 1157. [Abstract] [Full Text] [PDF] |
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H. K. Grogaard, L. Wik, M. Eriksen, M. Brekke, and K. Sunde Continuous Mechanical Chest Compressions During Cardiac Arrest to Facilitate Restoration of Coronary Circulation With Percutaneous Coronary Intervention J. Am. Coll. Cardiol., September 11, 2007; 50(11): 1093 - 1094. [Full Text] [PDF] |
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S Galea, S Blaney, A Nandi, R Silverman, D Vlahov, G Foltin, M Kusick, M Tunik, and N Richmond Explaining Racial Disparities in Incidence of and Survival from Out-of-Hospital Cardiac Arrest Am. J. Epidemiol., September 1, 2007; 166(5): 534 - 543. [Abstract] [Full Text] [PDF] |
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B. Ali and A. M. Zafari Narrative Review: Cardiopulmonary Resuscitation and Emergency Cardiovascular Care: Review of the Current Guidelines Ann Intern Med, August 7, 2007; 147(3): 171 - 179. [Abstract] [Full Text] [PDF] |
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D. J. Cantillon, K. M. Stein, S. M. Markowitz, S. Mittal, B. K. Shah, D. P. Morin, E. S. Zacks, M. Janik, S. Ageno, A. C. Mauer, et al. Predictive Value of Microvolt T-Wave Alternans in Patients With Left Ventricular Dysfunction J. Am. Coll. Cardiol., July 10, 2007; 50(2): 166 - 173. [Abstract] [Full Text] [PDF] |
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D. H. Birnie MB ChB MD, C. Sambell BSc, H. Johansen PhD, K. Williams MS, R. Lemery MD, M. S. Green MD, M. H. Gollob MD, D. S. Lee MD PhD, and A. S.L. Tang MD Use of implantable cardioverter defibrillators in Canadian and US survivors of out-of-hospital cardiac arrest Can. Med. Assoc. J., July 3, 2007; 177(1): 41 - 46. [Abstract] [Full Text] [PDF] |
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D. L. Jardine, C. J. Charles, C. M. Frampton, and A. M. Richards Cardiac sympathetic nerve activity and ventricular fibrillation during acute myocardial infarction in a conscious sheep model Am J Physiol Heart Circ Physiol, July 1, 2007; 293(1): H433 - H439. [Abstract] [Full Text] [PDF] |
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H. T Carew, W. Zhang, and T. D Rea Chronic health conditions and survival after out-of-hospital ventricular fibrillation cardiac arrest Heart, June 1, 2007; 93(6): 728 - 731. [Abstract] [Full Text] [PDF] |
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W. G. Tingley, L. Pawlikowska, J. G. Zaroff, T. Kim, T. Nguyen, S. G. Young, K. Vranizan, P.-Y. Kwok, M. A. Whooley, and B. R. Conklin Gene-trapped mouse embryonic stem cell-derived cardiac myocytes and human genetics implicate AKAP10 in heart rhythm regulation PNAS, May 15, 2007; 104(20): 8461 - 8466. [Abstract] [Full Text] [PDF] |
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P. J. Zimetbaum A 59-Year-Old Man Considering Implantation of a Cardiac Defibrillator JAMA, May 2, 2007; 297(17): 1909 - 1916. [Abstract] [Full Text] [PDF] |
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I. G. Stiell, R. G. Walker, L. P. Nesbitt, F. W. Chapman, D. Cousineau, J. Christenson, P. Bradford, S. Sookram, R. Berringer, P. Lank, et al. BIPHASIC Trial: A Randomized Comparison of Fixed Lower Versus Escalating Higher Energy Levels for Defibrillation in Out-of-Hospital Cardiac Arrest Circulation, March 27, 2007; 115(12): 1511 - 1517. [Abstract] [Full Text] [PDF] |
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E. C. Keeley and L. D. Hillis Primary PCI for Myocardial Infarction with ST-Segment Elevation N. Engl. J. Med., January 4, 2007; 356(1): 47 - 54. [Full Text] [PDF] |
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M. L. Weisfeldt and S. J. Zieman Advances In The Prevention And Treatment Of Cardiovascular Disease Health Aff., January 1, 2007; 26(1): 25 - 37. [Abstract] [Full Text] [PDF] |
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T. D. Rea, M. Helbock, S. Perry, M. Garcia, D. Cloyd, L. Becker, and M. Eisenberg Increasing Use of Cardiopulmonary Resuscitation During Out-of-Hospital Ventricular Fibrillation Arrest: Survival Implications of Guideline Changes Circulation, December 19, 2006; 114(25): 2760 - 2765. [Abstract] [Full Text] [PDF] |
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H. Losert, F. Sterz, K. Kohler, G. Sodeck, R. Fleischhackl, P. Eisenburger, A. Kliegel, H. Herkner, H. Myklebust, J. Nysaether, et al. Quality of Cardiopulmonary Resuscitation Among Highly Trained Staff in an Emergency Department Setting Arch Intern Med, November 27, 2006; 166(21): 2375 - 2380. [Abstract] [Full Text] [PDF] |
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Developed in Collaboration With the European Heart, D. P. Zipes, A. J. Camm, M. Borggrefe, A. E. Buxton, B. Chaitman, M. Fromer, G. Gregoratos, G. Klein, A. J. Moss, et al. ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death--Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death) J. Am. Coll. Cardiol., September 5, 2006; 48(5): 1064 - 1108. [Full Text] [PDF] |
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Developed in Collaboration With the European Heart, D. P. Zipes, A. J. Camm, M. Borggrefe, A. E. Buxton, B. Chaitman, M. Fromer, G. Gregoratos, G. Klein, A. J. Moss, et al. ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: A Report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death) J. Am. Coll. Cardiol., September 5, 2006; 48(5): e247 - e346. [Full Text] [PDF] |
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D. P. Zipes, D. P. Zipes, A. J. Camm, M. Borggrefe, A. E. Buxton, B. Chaitman, M. Fromer, G. Gregoratos, G. Klein, A. J. Moss, et al. ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death--executive summary: A report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death) Developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. Eur. Heart J., September 1, 2006; 27(17): 2099 - 2140. [Full Text] [PDF] |
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Writing Committee Members, D. P. Zipes, A. J. Camm, M. Borggrefe, A. E. Buxton, B. Chaitman, M. Fromer, G. Gregoratos, G. Klein, A. J. Moss, et al. ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: A report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death) Developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society Europace, September 1, 2006; 8(9): 746 - 837. [Full Text] [PDF] |
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M. E. H. Ong, J. P. Ornato, D. P. Edwards, H. S. Dhindsa, A. M. Best, C. S. Ines, S. Hickey, B. Clark, D. C. Williams, R. G. Powell, et al. Use of an automated, load-distributing band chest compression device for out-of-hospital cardiac arrest resuscitation. JAMA, June 14, 2006; 295(22): 2629 - 2637. [Abstract] [Full Text] [PDF] |
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Y. Gerber, S. J. Jacobsen, R. L. Frye, S. A. Weston, J. M. Killian, and V. L. Roger Secular Trends in Deaths From Cardiovascular Diseases: A 25-Year Community Study Circulation, May 16, 2006; 113(19): 2285 - 2292. [Abstract] [Full Text] [PDF] |
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D. A. Cesario and G. W. Dec Implantable Cardioverter- Defibrillator Therapy in Clinical Practice J. Am. Coll. Cardiol., April 18, 2006; 47(8): 1507 - 1517. [Abstract] [Full Text] [PDF] |
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N. Sotoodehnia, D. S. Siscovick, M. Vatta, B. M. Psaty, R. P. Tracy, J. A. Towbin, R. N. Lemaitre, T. D. Rea, J. P. Durda, J. M. Chang, et al. {beta}2-Adrenergic Receptor Genetic Variants and Risk of Sudden Cardiac Death Circulation, April 18, 2006; 113(15): 1842 - 1848. [Abstract] [Full Text] [PDF] |
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T. Aufderheide, M. F. Hazinski, G. Nichol, S. S. Steffens, A. Buroker, R. McCune, E. Stapleton, V. Nadkarni, J. Potts, R. R. Ramirez, et al. Community Lay Rescuer Automated External Defibrillation Programs: Key State Legislative Components and Implementation Strategies: A Summary of a Decade of Experience for Healthcare Providers, Policymakers, Legislators, Employers, and Community Leaders From the American Heart Association Emergency Cardiovascular Care Committee, Council on Clinical Cardiology, and Office of State Advocacy Circulation, March 7, 2006; 113(9): 1260 - 1270. [Abstract] [Full Text] [PDF] |
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K. Anand, A. N Mooss, and S. M Mohiuddin Review: Aldosterone Inhibition Reduces the Risk of Sudden Cardiac Death in Patients with Heart Failure Journal of Renin-Angiotensin-Aldosterone System, March 1, 2006; 7(1): 15 - 19. [Abstract] [PDF] |
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C. W. Israel and S. H. Hohnloser Automated external defibrillation in emergency medical systems: what has been achieved and where to go? Eur. Heart J., March 1, 2006; 27(5): 508 - 509. [Full Text] [PDF] |
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T. Thom, N. Haase, W. Rosamond, V. J. Howard, J. Rumsfeld, T. Manolio, Z.-J. Zheng, K. Flegal, C. O'Donnell, S. Kittner, et al. Heart Disease and Stroke Statistics--2006 Update: A Report From the American Heart Association Statistics Committee and Stroke Statistics Subcommittee Circulation, February 14, 2006; 113(6): e85 - e151. [Full Text] [PDF] |
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S. M. Narayan T-Wave Alternans and the Susceptibility to Ventricular Arrhythmias J. Am. Coll. Cardiol., January 17, 2006; 47(2): 269 - 281. [Abstract] [Full Text] [PDF] |
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