Contribution of sudden cardiac death to total mortality in India - a population based study.
BACKGROUND
Epidemiology of sudden cardiac death (SCD) in India is understudied.


METHODS
We assessed proportion of SCD among total mortality in a population in Southern India using a staged, questionnaire-based kindred-wide approach. Detailed questionnaires (DQs) were completed by medical trainees from 8 medical colleges. Preliminary questionnaires evaluated total deaths in the kindred of a respondent. Deaths due to obvious non-cardiac causes were excluded. DQs were completed for the remaining deaths and categorized using a three-member adjudication system.


RESULTS
A total population of 22,724 was evaluated by 478 respondents, (278 M and 200 F). Out of a total of 2185 deaths, 1691 (77.4%) were recallable. A total of 173 (10.3%; 128 M and 45 F; mean age - 60.8 ± 14 years) deaths were adjudicated as SCD. Of these, 82 (47.3%) were ≤ 60 years of age. Prior MI, LV dysfunction and prior aborted SCD were found in 33.5%, 22.5% and 5.7% respectively. Coronary artery disease (CAD) was observed in 66 (38%) and acute myocardial infarction documented in 30 (17%). At least 1 of 3 CAD risk factors - hypertension, diabetes, or smoking was observed in 80.6%. Proportion of subjects with at least one risk factor for CAD were similar in the age groups above and below 50 years (67.6% vs. 81.7%, p=0.065).


CONCLUSIONS
SCD contributed to 10.3% of overall mortality in this population from Southern India. On an average, SCD cases were 5-8 years younger compared to populations reported in the western hemisphere, with a high prevalence of major risk factors for CAD.
Rao
B Hygriv
BH
CARE Hospitals Hyderabad, India. hygriv@hotmail.com
Sastry
B K S
BK
Chugh
Sumeet S
SS
Kalavakolanu
Sharada
S
Christopher
Johann
J
Shangula
Deepika
D
Korabathina
Radhika
R
Raju
P Krishnam
PK
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D003324:Coronary Artery Disease / Q000401:mortality*; D016757:Death, Sudden, Cardiac / Q000453:epidemiology*; D003906:Developing Countries / Q000706:statistics & numerical data; D003920:Diabetes Mellitus / Q000401:mortality; D005260:Female; D006801:Humans; D006973:Hypertension / Q000401:mortality; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality*; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000401:mortality; D011795:Surveys and Questionnaires