Distinctive Clinical Profile of Blacks versus Whites Presenting with Sudden Cardiac Arrest
Background—Sudden cardiac arrest (SCA) is a major contributor to mortality, but data are limited among non-whites. Identification of differences in clinical profile based on race may provide opportunities for improved SCA prevention.
Methods and Results—In the ongoing Oregon Sudden Unexpected Death Study (SUDS), individuals suffering SCA in the Portland, Oregon metropolitan area were identified prospectively. Patient demographics, arrest circumstances, and pre-SCA clinical profile were compared by race, among cases 2002 - 2012 (for clinical history, n = 126 blacks, 1262 whites). Incidence rates were calculated for cases from the burden assessment phase (2002 - 2005; n = 1077). Age-adjusted rates were two-fold higher among black men and women (175 and 90 per 100,000, respectively), compared to white men and women (84 and 40 per 100,000, respectively). Compared to whites, blacks were >6 years younger at the time of SCA and had a higher pre-arrest prevalence of diabetes (52% vs. 33%, p<0.0001), hypertension (77% vs. 65%, p=0.006), and chronic renal insufficiency (34% vs. 19%, p<0.0001). There were no racial differences in previously documented coronary artery disease or left ventricular dysfunction, but blacks had more prevalent congestive heart failure (43% vs. 34%, p=0.04), left ventricular hypertrophy (77% vs. 58%, p=0.02), and a longer QT interval (QTc) (466 ± 36 vs. 453 ± 41, p=0.03).
Conclusions—In this US Community, the burden of SCA was significantly higher in blacks compared to whites. Blacks with SCA had a higher pre-arrest prevalence of risk factors beyond established CAD, providing potential targets for race-specific prevention.
- Received January 23, 2015.
- Revision received May 1, 2015.
- Accepted May 28, 2015.