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A prospective study of sudden cardiac death among children and young adults

Citation

Bagnall, RD and Weintraub, RG and Ingles, J and Duflou, J and Yeates, L and Lam, L and Davis, AM and Thompson, T and Connell, V and Wallace, J and Naylor, C and Crawford, J and Love, DR and Hallam, L and White, J and Lawrence, C and Lynch, M and Morgan, N and James, P and Du Sart, D and Puranik, R and Langlois, N and Vohra, J and Winship, I and Atherton, J and McGaughran, J and Skinner, JR and Semsarian, C, A prospective study of sudden cardiac death among children and young adults, New England Journal of Medicine, 374, (25) pp. 2441-2452. ISSN 0028-4793 (2016) [Refereed Article]


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Copyright Statement

Copyright 2016 Massachusetts Medical Society

DOI: doi:10.1056/NEJMoa1510687

Abstract

Background: Sudden cardiac death among children and young adults is a devastating event. We performed a prospective, population-based, clinical and genetic study of sudden cardiac death among children and young adults.

Methods: We prospectively collected clinical, demographic, and autopsy information on all cases of sudden cardiac death among children and young adults 1 to 35 years of age in Australia and New Zealand from 2010 through 2012. In cases that had no cause identified after a comprehensive autopsy that included toxicologic and histologic studies (unexplained sudden cardiac death), at least 59 cardiac genes were analyzed for a clinically relevant cardiac gene mutation.

Results: A total of 490 cases of sudden cardiac death were identified. The annual incidence was 1.3 cases per 100,000 persons 1 to 35 years of age; 72% of the cases involved boys or young men. Persons 31 to 35 years of age had the highest incidence of sudden cardiac death (3.2 cases per 100,000 persons per year), and persons 16 to 20 years of age had the highest incidence of unexplained sudden cardiac death (0.8 cases per 100,000 persons per year). The most common explained causes of sudden cardiac death were coronary artery disease (24% of cases) and inherited cardiomyopathies (16% of cases). Unexplained sudden cardiac death (40% of cases) was the predominant finding among persons in all age groups, except for those 31 to 35 years of age, for whom coronary artery disease was the most common finding. Younger age and death at night were independently associated with unexplained sudden cardiac death as compared with explained sudden cardiac death. A clinically relevant cardiac gene mutation was identified in 31 of 113 cases (27%) of unexplained sudden cardiac death in which genetic testing was performed. During follow-up, a clinical diagnosis of an inherited cardiovascular disease was identified in 13% of the families in which an unexplained sudden cardiac death occurred.

Conclusions: The addition of genetic testing to autopsy investigation substantially increased the identification of a possible cause of sudden cardiac death among children and young adults.

Item Details

Item Type:Refereed Article
Research Division:Medical and Health Sciences
Research Group:Cardiorespiratory Medicine and Haematology
Research Field:Cardiology (incl. Cardiovascular Diseases)
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Cardiovascular System and Diseases
Author:Lawrence, C (Dr Chris Lawrence)
ID Code:122009
Year Published:2016
Web of Science® Times Cited:42
Deposited By:Medicine (Discipline)
Deposited On:2017-10-25
Last Modified:2017-11-03
Downloads:9 View Download Statistics

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