Cardiovascular Division, Brooke Army Medical Center, San Antonio, Texas 78234, USA.
J Am Coll Cardiol. 2011 Sep 13;58(12):1254-61. doi: 10.1016/j.jacc.2011.01.049.
The purpose of this study was to define the incidence and characterization of cardiovascular cause of sudden death in the young.
The epidemiology of sudden cardiac death (SCD) in young adults is based on small studies and uncontrolled observations. Identifying causes of sudden death in this population is important for guiding approaches to prevention.
We performed a retrospective cohort study using demographic and autopsy data from the Department of Defense Cardiovascular Death Registry over a 10-year period comprising 15.2 million person-years of active surveillance.
We reviewed all nontraumatic sudden deaths in persons 18 years of age and over. We identified 902 subjects in whom the adjudicated cause of death was of potential cardiac etiology, with a mean age of 38 ± 11 years. The mortality rate for SCD per 100,000 person-years for the study period was 6.7 for males and 1.4 for females (p < 0.0001). Sudden death was attributed to a cardiac condition in 715 (79.3%) and was unexplained in 187 (20.7%). The incidence of sudden unexplained death (SUD) was 1.2 per 100,000 person-years for persons <35 years of age, and 2.0 per 100,000 person-years for those ≥ 35 years of age (p < 0.001). The incidence of fatal atherosclerotic coronary artery disease was 0.7 per 100,000 person-years for those <35 years of age, and 13.7 per 100,000 person-years for those ≥ 35 years of age (p < 0.001).
Prevention of sudden death in the young adult should focus on evaluation for causes known to be associated with SUD (e.g., primary arrhythmia) among persons <35 years of age, with an emphasis on atherosclerotic coronary disease in those ≥ 35 years of age.
本研究旨在确定年轻人中心血管性猝死的发生率和特征。
年轻成年人心脏性猝死 (SCD) 的流行病学基于小型研究和非对照观察。确定该人群中猝死的原因对于指导预防方法很重要。
我们使用国防部心血管死亡登记处的人口统计学和尸检数据进行了一项回顾性队列研究，该研究涵盖了 10 年期间的 1520 万人年的主动监测。
我们审查了所有年龄在 18 岁及以上的非创伤性猝死病例。我们确定了 902 名被判定为潜在心脏病因的死亡原因，平均年龄为 38 ± 11 岁。研究期间 SCD 的死亡率为每 10 万人年 6.7 例，男性为 1.4 例（p < 0.0001）。902 例中 715 例（79.3%）归因于心脏疾病，187 例（20.7%）原因不明。年龄 <35 岁的人突然不明原因死亡（SUD）的发生率为每 100,000 人年 1.2 例，年龄≥35 岁的人发生率为每 100,000 人年 2.0 例（p < 0.001）。年龄 <35 岁的人致命性动脉粥样硬化性冠状动脉疾病的发生率为每 100,000 人年 0.7 例，年龄≥35 岁的人发生率为每 100,000 人年 13.7 例（p < 0.001）。
预防年轻成年人的猝死应侧重于评估与 SUD 相关的已知原因（例如，原发性心律失常），年龄 <35 岁的人应重点关注动脉粥样硬化性冠状动脉疾病，年龄≥35 岁的人应重点关注动脉粥样硬化性冠状动脉疾病。
