Department of Cardiology, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark
Department of Cardiology, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark.
Heart. 2021 Aug;107(16):1303-1309. doi: 10.1136/heartjnl-2020-318881. Epub 2021 May 21.
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.
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.
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.
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.
为了开发有意义的心脏性猝死（SCD）预测指标，我们需要更多关于普通人群中 SCD 发展的知识。本研究旨在评估普通人群中 SCD 的发生率，并检查其时间变化、人口统计学和临床特征。
所有参与哥本哈根城市心脏研究的参与者均在 1993 年至 2016 年期间进行了随访。所有死亡证明、尸检报告和国家登记数据均用于识别所有 SCD 病例。
本研究共纳入 14562 例受试者。共有 8394 例死亡病例，所有信息均可获得，其中 1335 例归类为 SCD。在研究期间，40-90 岁人群的 SCD 发生率下降了 41%，标准化发病率从 504 例/10 万人年（95%CI 447 至 569）降至 237 例/10 万人年（95%CI 195 至 289）。≤75 岁男性和女性的 SCD 发生率比值为 1.99（95%CI 1.62 至 2.46）。观察期间，所有心脏性死亡中 SCD 的比例下降，且随年龄增长而下降。男性有更多的心血管合并症（OR 1.34，95%CI 1.07 至 1.68，p<0.01），并且 SCD 是所有病例中 50%首次登记的心脏疾病表现。
在研究期间，普通人群中 SCD 的发生率显著下降，但应进一步调查最近的变化以及 SCD 低至中危人群的新型风险预测指标。
