Exploring the Risk Factors of Sudden Cardiac Death Using an Electrocardiography and Medical Ultrasonography for the General Population Without a History of Coronary Artery Disease or Left Ventricular Ejection Fraction <35% and Aged >35 Years

Background: Most of the factors and prediction models of sudden cardiac death (SCD) have been developed without considering the Asia population. The purpose of this study is to construct a point-based prediction model for the general population in Asia. Methods and Results: Chin-Shan Community Cardiovascular Cohort (CCCC) is a community-based longitudinal cohort initiated between 1990 and 1991, enrolling participants aged >= 35 years and following them up until 2005. Participants with coronary artery disease (CAD) or a left ventricular ejection fraction (LVEF) of 35% were excluded from this study. The Framingham risk score function was used to derive a simple point-based prediction model. Based on bootstrapping, a novel model (CCCC-SCD-Score) was validated. A total of 2,105 participants were analyzed. The incidence rate of SCD was 0.406 per 1,000 person-years. The CCCC-SCD-Score score was calculated using age groups (maximal points=4), left ventricular hypertrophy, hypertension, left ventricular ejection fraction < 40%, aortic flow rate > 190 cm/s, and carotid plaque scores >= 5 (point=1 for each risk factor). The C-index of the CCCC-SCD-Score in predicting SCD risks was 0.888 (95% confidence interval: 0.807-0.969). Conclusions: For the general Asian population without a history of CAD or a LVEF < 35% and who are aged > 35 years, the novel model-based scoring system effectively identifies the risk for SCD using the clinical factors, electrocardiographic and echocardio-graphic data.

Automated summary

This study aimed to develop a point-based prediction model for sudden cardiac death (SCD) in the general Asian population. A community-based longitudinal cohort study was conducted, and a novel scoring system (CCCC-SCD-Score) was derived using clinical factors, electrocardiographic and echocardiographic data. The model effectively identified the risk for SCD in Asians without a history of coronary artery disease or low left ventricular ejection fraction.