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Arrhythmias and sudden death
Original research
Temporal trends and sex differences in sudden cardiac death in the Copenhagen City Heart Study
  1. Frederik Nybye Ågesen1,
  2. Thomas Hadberg Lynge1,
  3. Paul Blanche1,2,3,
  4. Jytte Banner4,
  5. Eva Prescott5,6,
  6. Reza Jabbari1,
  7. Jacob Tfelt-Hansen1,4
  1. 1 Department of Cardiology, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark
  2. 2 Department of Cardiology, University of Copenhagen, Gentofte, Denmark
  3. 3 Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark
  4. 4 Department of Forensic Medicine, Faculty of Health and Medical Sciences, Copenhagen, Denmark
  5. 5 Department of Cardiology, University of Copenhagen, Bispebjerg Hospital, Copenhagen, Denmark
  6. 6 Copenhagen City Heart Study, Frederiksberg Hospital, Copenhagen, Denmark
  1. Correspondence to Dr Frederik Nybye Ågesen, Department of Cardiology, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark; frederik.nybye.aagesen{at}regionh.dk

Abstract

Objective More knowledge about the development of sudden cardiac death (SCD) in the general population is needed to develop meaningful predictors of SCD. Our aim with this study was to estimate the incidence of SCD in the general population and examine the temporal changes, demographics and clinical characteristics.

Methods All participants in the Copenhagen City Heart Study were followed from 1993 to 2016. All death certificates, autopsy reports and national registry data were used to identify all cases of SCD.

Results A total of 14 562 subjects were included in this study. There were 8394 deaths with all information available, whereof 1335 were categorised as SCD. The incidence of SCD decreased during the study period by 41% for persons aged 40–90 years, and the standardised incidence rates decreased from 504 per 100 000 person-years (95% CI 447 to 569) to 237 per 100 000 person-years (95% CI 195 to 289). The incidence rate ratio of SCD between men and women ≤75 years was 1.99 (95% CI 1.62 to 2.46). The proportion of SCD of all cardiac deaths decreased during the observation period and decreased with increasing age. Men had more cardiovascular comorbidities (OR 1.34, 95% CI 1.07 to 1.68, p<0. 01), and SCD was the first registered manifestation of cardiac disease in 50% of all cases.

Conclusion The incidence of SCD in the general population has declined significantly during the study period but should be further investigated for more recent variations as well as novel risk predictors for persons with low to medium risk of SCD.

  • epidemiology
  • risk factors
  • arrhythmias
  • cardiac
  • coronary artery disease
  • global burden of disease

Data availability statement

Deidentified data are not publicly available but may be obtained after permission directly from the Copenhagen City Heart Study (anja.lykke.madsen@regionh.dk).

https://doi.org/10.1136/heartjnl-2020-318881

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    Data availability statement

    Deidentified data are not publicly available but may be obtained after permission directly from the Copenhagen City Heart Study (anja.lykke.madsen@regionh.dk).

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    Footnotes

    • RJ and JT-H are joint senior authors.

    • Contributors JT-H, RJ and EP wrote the study protocol. JT-H, RJ, THL and FNÅ reviewed death certificates. FNÅ wrote the first draft of the manuscript. All authors contributed to the further development of the manuscript, discussed the results and helped to complete the manuscript for publication. All authors have approved the final version of the manuscript for submission.

    • Funding This project has received funding from the European Union’s Horizon 2020 research and innovation programme ESCAPE-NET (grant number: 733381).

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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