Abstract 18012: Vital Exhaustion is Not Associated With an Increased Risk of Sudden Cardiac Death: The Atherosclerosis Risk in Communities (ARIC) Study
Introduction: Vital exhaustion (VE) is a construct characterized by lack of energy, increased fatigue, irritability, and demoralization. Although multiple small studies suggest a positive association between vital exhaustion and sudden cardiac death (SCD), most have limited follow up and did not validate the classification of SCD. We examined the association between VE and SCD in the large, well-characterized, Atherosclerosis Risk in Communities (ARIC) Study cohort.
Hypothesis: We hypothesized that VE was positively associated with SCD.
Methods: ARIC is a biracial cohort of men and women, aged 45-64 at baseline, initiated in 1987 through random sampling in 4 US communities. VE was measured using the Maastricht questionnaire during the second examination (1990-1992) among 14,328 individuals. Cox proportional hazards models were used to examine the hazard of SCD across tertiles of VE scores. Three SCD definitions were evaluated: 1) fatal coronary heart disease death within 1 hour, 2) fatal coronary heart disease death within 24 hours of symptom onset, and 3) a sudden pulseless condition presumed due to a ventricular tachyarrhythmia in a stable individual without evidence of non-cardiac cause as determined by physician review of available information.
Results: Through 2012, the number of SCD events totaled 253, 458, and 472, for the 3 definitions, respectively. Adjusting for age, sex, and race-center, participants in the highest VE tertile had an increased risk of SCD, compared to those in the lowest tertile, for all definitions of SCD (HR=1.51 95% CI: 1.12-2.05; HR=1.60 95% CI: 1.27-2.02; and HR=1.54 95% CI: 1.22-1.94, respectively). However, after further adjustment for cardiovascular disease history, body mass index, smoking status, diabetes, systolic and diastolic blood pressure, antihypertensive medication use, total and HDL-cholesterol levels, no significant increase in risk was observed (HR=0.97 95% CI: 0.70-1.33; HR=1.08 95% CI: 0.85-1.38; and HR=0.99 95% CI: 0.77-1.25, respectively).
Conclusions: In contrast to past studies in smaller cohorts with less follow up time, among participants of the ARIC study, VE was not associated with an increased risk for any of the examined definitions of SCD after adjustment for cardiovascular risk factors.
Author Disclosures: B.M. Bogle: None. N. Sotoodehnia: None. A. Kucharska-Newton: None. W.D. Rosamond: None.
- © 2016 by American Heart Association, Inc.