Obesity in young sudden cardiac death: Rates, clinical features, and insights into people with body mass index >50kg/m2

Obesity in young sudden cardiac death: Rates, clinical features, and insights into people with body mass index >50kg/m2.

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Item Type: Article
Status: Published
Official URL: https://doi.org/10.1016/j.ajpc.2022.100369
Journal or Publication Title: American Journal of Preventive Cardiology
Volume: 11
Page Range: p. 100369
Date: September 2022
Divisions: Molecular Cardiology
Depositing User: General Admin
Identification Number: 10.1016/j.ajpc.2022.100369
ISSN: 26666677
Date Deposited: 17 Apr 2023 01:32

Objective: To contextualize obesity rates in young sudden cardiac death (SCD) against the age-matched national population, and identify clinical and pathologic features in WHO class II and III obesity.

Methods: A prospective state-wide out-of-hospital cardiac arrest registry included all SCDs in Victoria, Australia from 2019-2021. Body mass indices (BMIs) of patients 18-50 years were compared to age-referenced general population. Characteristics of SCD patients with WHO Class II obesity (BMI ≥30kg/m2) and non-obesity (BMI<30kg/m2) were compared. Clinical characteristics of people with BMI>50kg/m2 were assessed.

Results: 504 patients were included. Obesity was strongly over-represented in young SCD compared to the age-matched general population (55.0% vs 28.7%, p<0.0001). Obese SCD patients more frequently had hypertension, diabetes and obstructive sleep apnoea (p<0.0001, p=0.009 and p=0.001 respectively), ventricular fibrillation as their arrest rhythm (p=0.008) and left ventricular hypertrophy (LVH) (p<0.0001). Obese patients were less likely to have toxicology positive for illicit substances (22.0% vs 32.6%, p=0.008) or history of alcohol abuse (18.8% vs 26.9%, p=0.030). Patients with BMI>50 kg/m2 represented 8.5% of young SCD. LVH (n=26, 60.5%) was their predominant cause of death and only 10 (9.3%) patients died from coronary disease.

Conclusion: Over half of young Australian SCD patients are obese, with all obesity classes over-represented compared to the general population. Obese patients had more cardiac risk factors. Almost two thirds of patients with BMI>50 kg/m2 died from LVH, with fewer than 10% dying from coronary disease.

Keywords: BMI, body mass index; Cardiomyopathy; EndUCD, End Unexplained Cardiac Death Registry; Extreme obesity; OHCA, out of hospital cardiac arrest; Obesity; SCD, sudden cardiac death; Sudden cardiac death; VIFM, Victorian Institute of Forensic Medicine.

Paratz, Elizabeth D
Ashokkumar, Srikkumar
van Heusden, Alexander
Smith, Karen
Zentner, Dominica
Morgan, Natalie
Parsons, Sarah
Thompson, Tina
James, Paul
Connell, Vanessa
Pflaumer, Andreas
Semsarian, Chris
Ingles, Jodie
Stub, Dion
Gerche, Andre La
Last Modified: 17 Apr 2023 01:32
URI: https://eprints.centenary.org.au/id/eprint/1458

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