Overview

Sex and Racial Differences in Autopsy-Defined Causes of Sudden Cardiac Death
We found that Black women experienced higher rates of autopsy-defined sudden arrhythmic death than white women, while Asian and Hispanic men had lower rates than white men.

Sudden cardiac death (SCD) is a leading cause of mortality in the United States, yet incidence estimates vary widely due to inconsistent data sources and definitions. Conventional definitions of SCD presume cardiac cause and have limited accuracy for actual arrhythmic deaths.

In the POstmortem Systematic InvesTigation of Sudden Cardiac Death (POST SCD) study, we prospectively identified all World Health Organization-defined adult SCDs in San Francisco county over a 5 year period and completed comprehensive antemortem medical records review and autopsy to refine true causes of death.

Key takeaways:

  • Only half (55.8%) of sudden cardiac deaths defined by conventional criteria were autopsy-defined sudden arrhythmic deaths
  • Leading causes of presumed sudden cardiac deaths were coronary disease (32%), occult overdose (13.5%), cardiomyopathy (10%), cardiac hypertrophy (8%), and neurological (5.5%)

Using these findings, we are improving the way we define SCDs. Doing so affords more accurate surveilance, identification, and investigation into the true causes of SCD.  

Our refined definitions of SCD allow us to identify differences in SCD causes by sex and race. In our study, we found that women had more non-ischemic and non-cardiac causes of SCD. Black women had higher rates of autopsy-defined sudden arrhythmic death than white women while Asian and Hispanic men had lower rates than white men. More information can be found in our recent publication, Sex and Racial Differences in Autopsy-Defined Causes of Presumed Sudden Cardiac Death

For more details, please refer to our publications, Prospective Countywide Surveillance and Autopsy Characterization of Sudden Cardiac Death: POST SCD Study and Refining the World Health Organization Definition.