title: Discrete event simulation model of sudden cardiac death predicts high impact of preventive interventions.
abstract: Sudden Cardiac Death (SCD) is responsible for at least 180,000 deaths a year and incurs an average cost of $286 billion annually in the United States alone. Herein, we present a novel discrete event simulation model of SCD, which quantifies the chains of events associated with the formation, growth, and rupture of atheroma plaques, and the subsequent formation of clots, thrombosis and on-set of arrhythmias within a population. The predictions generated by the model are in good agreement both with results obtained from pathological examinations on the frequencies of three major types of atheroma, and with epidemiological data on the prevalence and risk of SCD. These model predictions allow for identification of interventions and importantly for the optimal time of intervention leading to high potential impact on SCD risk reduction (up to 8-fold reduction in the number of SCDs in the population) as well as the increase in life expectancy.
authors: Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.
authors: Victor P
authors: VP
authors: Andreev
authors: Trajen
authors: T
authors: Head
authors: Neil
authors: N
authors: Johnson
authors: Sapna K
authors: SK
authors: Deo
authors: Sylvia
authors: S
authors: Daunert
authors: Pascal J
authors: PJ
authors: Goldschmidt-Clermont
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000150:complications / Q000473:pathology; D001777:Blood Coagulation / Q000502:physiology; D016757:Death, Sudden, Cardiac / Q000473:pathology* / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000150:complications / Q000473:pathology*; D012307:Risk Factors; D013927:Thrombosis / Q000150:complications / Q000473:pathology
references: J Hosp Med. 2012 Nov-Dec;7(9):706-8
references: 23024055
references: Ann Epidemiol. 1992 Jan-Mar;2(1-2):5-14
references: 1342264
references: J Interv Cardiol. 2002 Dec;15(6):439-46
references: 12476646
references: JAMA. 1999 Feb 24;281(8):727-35
references: 10052443
references: J Am Coll Cardiol. 2007 Sep 4;50(10):940-9
references: 17765120
references: Arterioscler Thromb Vasc Biol. 2000 May;20(5):1262-75
references: 10807742
references: Prog Cardiovasc Dis. 2008 Nov-Dec;51(3):213-28
references: 19026856
references: JAMA. 2002 Dec 18;288(23):3008-13
references: 12479765
references: Arterioscler Thromb Vasc Biol. 1999 Jun;19(6):1484-90
references: 10364079
references: Health Care Manag Sci. 2002 Nov;5(4):259-67
references: 12437273
references: Circulation. 1992 Jan;85(1 Suppl):I19-24
references: 1728500
references: Circulation. 2011 Feb 1;123(4):e18-e209
references: 21160056
references: Circulation. 1996 Sep 1;94(5):928-31
references: 8790027
references: Circulation. 2012 Feb 28;125(8):1043-52
references: 22371442
references: J Theor Biol. 2004 Apr 7;227(3):437-43
references: 15019510
references: Radiology. 2003 Jan;226(1):263-71
references: 12511700
references: Circulation. 2001 Feb 20;103(7):934-40
references: 11181466
references: Prog Cardiovasc Dis. 2002 Mar-Apr;44(5):349-56
references: 12024333
references: J Am Coll Cardiol. 2011 Nov 22;58(22):2332-9
references: 22093512
references: J Am Coll Cardiol. 2006 Apr 18;47(8 Suppl):C13-8
references: 16631505