title: Out of hospital sudden cardiac death in Italy: a population-based case-control study.
abstract: BACKGROUND
  Sudden cardiac death (SCD) is a major cause of death in western countries, with coronary heart disease (CHD) being the basis of over 70% of SCD. Incidence in high-CHD risk countries has already been studied, but this information is not available for Mediterranean low-CHD risk countries. Incidence is of paramount importance when cost-effectiveness rate of actions against SCD must be estimated.
  
  
  METHODS
  We estimated the incidence of SCD and its potential risk associated with clinical variables, by a means of a case-control study in a general practice setting. The enrolled general practitioners (GPs) provided data about the total number of their patients, and identified all their patients who suffered an out-of-hospital SCD during the previous 365 days. Two age-matched and gender-matched controls visiting GPs office after the SCD selection were also selected. We used a structured questionnaire to obtain information about potential risk factors for SCD. Covariates that were univariately associated with SCD were included in the multivariate regression analyses.
  
  
  RESULTS
  In a population of 297 340 (age greater than 14 years), a total of 230 cases were identified (0.77 per 1000 individuals), mostly occurring at home and among persons with known high cardiovascular risk. In the multivariate analysis only CHD (OR: 1.67; 95% CI: 1.09-2.58), arrhythmia (OR: 2.2; 95% CI: 1.3-3.9), obesity (OR: 2.3; 95% CI: 1.5-3.6), alcohol abuse (OR: 1.8; 95% CI: 1.2-2.7), and family history of CHD (OR 3.1; 95% CI: 1.8-5.3) resulted in a significant association with SCD.
  
  
  CONCLUSIONS
  The incidence of SCD in Italy is lower than that reported in high-CHD risk population, most of the cases occurring at home and among persons with known high cardiovascular risk. Implementing recommendations for these patients seems to be the most effective strategy to reduce the incidence of SCD.
authors.affiliation: Italian College of General Practitioners, Florence, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Filippi
authors.forename: Emiliano
authors.initials: E
authors.lastname: Sessa
authors.forename: Giampiero
authors.initials: G
authors.lastname: Mazzaglia
authors.forename: Serena
authors.initials: S
authors.lastname: Pecchioli
authors.forename: Rachele
authors.initials: R
authors.lastname: Capocchi
authors.forename: Francesca
authors.initials: F
authors.lastname: Caprari
authors.forename: Alessandro
authors.initials: A
authors.lastname: Scivales
authors.forename: Claudio
authors.initials: C
authors.lastname: Cricelli
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000150:complications; D001145:Arrhythmias, Cardiac / Q000150:complications; D016022:Case-Control Studies; D003327:Coronary Disease / Q000235:genetics / Q000401:mortality; D016757:Death, Sudden, Cardiac / Q000453:epidemiology*; D005194:Family Practice; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications; D012307:Risk Factors; D011795:Surveys and Questionnaires