Sudden Cardiac Death in US Young Adults, 1989-1996
Anecdotal evidence and case reports indicate that sudden cardiac death (SCD) occurs in adolescents and young adults. To investigate the epidemiologic pattern and secular trend of SCD among ages 15-34 years, we analyzed US Multiple Causes of Death data from 1989 to 1996. SCD is defined as death due to cardiac disease (ICD-9 codes: 390-398, 402 and 404-429)that occurred out of hospital or in emergency room. This definition has been used in prior studies with reasonable accuracy. Mortality rates were calculated using mid-year population estimates as the denominators, and standardized to 1970. In 1996, 3,000 sudden cardiac deaths occurred for this specific age group, which reflects a 10% increase from 1989 (n=2,719). The leading underlying causes of SCD were ischemic heart disease (ICD codes 410-414, and 429.2), and arrhythmias or cardiomyopathies (ICD codes 425-427), each accounting for 35% of all SCDs. SCD mortality rates were twice as high in men as in women, and increased with age. From 1989 to 1996, age-standardized SCD mortality rates increased in both men (+10%) and women (+31%) (⇓Figure). Although SCD is relatively rare in US adolescents and young adults, the increased trend of SCD mortality warrants further investigation. This is the first national surveillance report on SCD in young adults.