Abstract 19039: Higher Burden of Sudden Cardiac Death in African Americans: A Prospective, Community-Based Study
Introduction: Sudden cardiac death (SCD) is a major contributor to mortality in the US, but there is limited data on SCD in non-white minorities.
Hypothesis: Incidence rates and clinical profile of SCD vary significantly by race.
Methods: All SCD cases in a large northwest US community (pop. 679,348; 2002 - 2005) were identified prospectively using multi-source ascertainment. Race and ethnicity were obtained for 98% of 1174 total cases from medical records or death certificate and categorized as White, African American (AA), Asian (all non-Hispanic); and Hispanic (regardless of race). Age-specific incidence rates were calculated using US census 2003 county population estimates. Age-adjusted rates were calculated using the US standard 2000 population.
Results: In this predominantly white community, 971 (84.5%) of SCA cases were white, 106 (9.2%) were AA, 34 were Asian (3.0%), and 22 (1.9%) were Hispanic. Age-adjusted rates were highest among AA (122/100,000), 59/100,000 in Whites, 52/100,000 in Hispanics, and lowest among Asians (36/100,000). Age-specific rates showed AA had higher rates across all age categories (Figure). No race/ethnic differences were observed (p≥0.28) by sex, history of MI or CAD, or circumstances of SCD (cardiac arrest location, response time, percent with resuscitation attempted, initial rhythm, witnessed SCD, return of spontaneous circulation, or survival to hospital discharge). AA were younger than whites at the time of SCD (63.8 ± 18.7 vs. 69.8 ± 15.3, p=0.007). A higher proportion of AA were diabetic (50% vs. ≤33% in other groups; p=0.0001); and there was a trend toward higher comorbidity burden (35% AA with Charlson Index ≥4 vs. ≤25% in other groups; p=0.06).
Conclusions: In this US Community, African Americans had more than double the incidence of SCD compared to other race/ethnic groups, suffered SCD at a younger age, and with higher rates of diabetes.
- © 2013 by American Heart Association, Inc.