Abstract 16019: African American Race is Significantly Associated With Risk of Sudden Cardiac Death Among Diabetics
Introduction: Diabetes has been linked with increased risk of sudden cardiac death (SCD) in multiple studies but most were performed among Caucasians; and our current ability to risk-stratify diabetics is poor. We hypothesized that there are specific demographic and clinical factors associated with SCD among diabetics.
Methods: In an ongoing community-based study in Northwestern US, patients with coronary artery disease (CAD) and SCD were compared to controls with CAD from the same geographical area. Analysis was restricted to patients with diabetes, age ≥ 18 yrs. Diabetes mellitus was defined as a clinical history of diabetes, or use of insulin or oral hypoglycemic agent. Hypertension, respiratory disease, congestive heart failure (CHF), liver disease, atrial fibrillation (AF), chronic renal insufficiency (CRI), syncope, seizure and sleep apnea were identified from lifetime clinical history. Pearson's x2 test and independent samples t-test were used for case-control comparisons. Logistic regression was used to evaluate significant factors associated with SCD.
Results: Cases (n=588) were older compared to controls (n=185) (68±12 yrs vs 65±12 yrs, p=0.0002) with no difference in gender distribution (p=0.85). African American race was more common among cases than controls (11% vs. 2%), White race was more common in controls (91% vs. 81%) (p=0.002) with similar distribution of Asian, Hispanic or other races. Cases were more likely to have CHF (43% vs. 27%, p=0.0001) and AF (28% vs. 18%, p=0.01). Cases were somewhat more likely to have CRI (p=0.06) and sleep apnea (p=0.07). There was no significant difference between cases and controls in other co-morbidities (p≥0.21). African American race was a significant predictor of SCD after adjustment for variables found significant in univariate analysis [OR 5.5 (95% CI 1.9-15.7)]. Age and heart failure were also significant determinants of SCD (p≤0.01). In an identical analysis between non-diabetic cases vs. controls, there was no difference in race distribution (p=0.60).
Conclusion: In this community-based study of diabetic patients with CAD, African American race was independently associated with risk of SCD. These findings warrant evaluation in additional, larger multi-ethnic community-based studies.
- © 2011 by American Heart Association, Inc.