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Original research
Sex differences in sudden cardiac death in a nationwide study of 54 028 deaths
  1. Tobias Skjelbred1,
  2. Deepthi Rajan1,
  3. Jesper Svane1,
  4. Thomas Hadberg Lynge1,
  5. Jacob Tfelt-Hansen1,2
  1. 1Department of Cardiology, The Heart Centre, Rigshospitalet, Copenhagen, Denmark
  2. 2Section of Forensic Genetics, University of Copenhagen, Kobenhavn, Denmark
  1. Correspondence to Tobias Skjelbred, Department of Cardiology, The Heart Centre, Rigshospitalet, Copenhagen, Denmark; tobias.skjelbred{at}regionh.dk

Abstract

Objective Sudden cardiac death (SCD) is a leading cause of death and is more common among males than females. Epidemiological studies of sex differences in SCD cases of all ages are sparse. The aim of this study was to examine differences in incidence rates, clinical characteristics, comorbidities and autopsy findings between male and female SCD cases.

Methods All deaths in Denmark in 2010 (54 028) were reviewed. Autopsy reports, death certificates, discharge summaries and nationwide health registries were reviewed to identify cases of SCD. Based on the available information, all deaths were subcategorised into definite, probable and possible SCD.

Results A total of 6867 SCD cases were identified, of which 3859 (56%) were males and 3008 (44%) were females. Incidence rates increased with age and were higher for male population across all age groups in the adult population. Average age at time of SCD was 71 years among males compared with 79 among females (p<0.01). The greatest difference in SCD incidence between males and females was found among the 35–50 years group with an incidence rate ratio of 3.7 (95% CI: 2.8 to 4.8). Compared with female SCD victims, male SCD victims more often had cardiovascular diseases and diabetes mellitus (p<0.01).

Conclusion This is the first nationwide study of sex differences in SCD across all ages. Differences in incidence rates between males and females were greatest among young adults and the middle-aged. Incidence rates of SCD among older female population approached that of the male population, despite having significantly more cardiovascular disease and diabetes in male SCD cases.

  • epidemiology
  • arrhythmias, cardiac

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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Footnotes

  • Twitter @TobiasSkjelbred

  • THL and JT-H contributed equally.

  • Contributors THL and JT-H have reviewed the death certificates and are joint senior authors of this manuscript. TS wrote the first draft of this manuscript. All authors have been involved in the further development of the manuscript, discussed the data and prepared the manuscript for submission. TS acted as gaurantor of this manuscript. All authors have approved the final draft of the manuscript before submission.

  • Funding This work was supported by Novo Nordisk Foundation, Copenhagen, Denmark (NNFOC140011573 and NNF18OC0031634).

  • 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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