title: Diabetes mellitus, high BMI and low education level predict sudden cardiac death within 24 hours of incident myocardial infarction.
abstract: More than half of cardiovascular mortality occurs outside the hospital, mainly due to consistently low survival rates from out-of-hospital cardiac arrest.
  
  
  
  This is a prospective, nested, case-control study derived from the Västerbotten Intervention Programme and the World Health Organization's Multinational Monitoring of Trends and Determinants in Cardiovascular Disease study in northern Sweden (1986-2006). To determine predictors for sudden cardiac death risk factors for cardiovascular disease were compared between incident myocardial infarction with sudden cardiac death (n = 363) and survivors of incident myocardial infarction (n = 1998) using multivariate logistic regression analysis.
  
  
  
  Diabetes had the strongest association with sudden cardiac death out of all evaluated risk factors (odds ratio (OR) 1.83, 95% confidence interval (CI) 1.30-2.59), followed by low education (OR 1.55, 95% CI 1.19-2.01), high body mass index (OR 1.05, 95% CI 1.02-1.08) and male sex (OR 1.42, 95% CI 1.001-2.01).
  
  
  
  The pattern of risk factors for incident myocardial infarction is different among survivors and those who die within 24 hours. The risk factors that contribute the most to death within 24 hours are diabetes mellitus, high body mass index and low education level, and can be addressed at both the public health level and by general practitioners.
authors.affiliation: Department of Public Health and Clinical Medicine, Skellefteå Research Unit, Umeå University, Sweden jonas.so.andersson@vll.se.
authors.forename: Jonas
authors.initials: J
authors.lastname: Andersson
authors.affiliation: Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Sweden.
authors.forename: Patrik
authors.initials: P
authors.lastname: Wennberg
authors.affiliation: Department of Public Health and Clinical Medicine, Sunderby Research Unit, Umeå University, Sweden.
authors.forename: Dan
authors.initials: D
authors.lastname: Lundblad
authors.affiliation: Genetic and Molecular Epidemiology Unit, Lund University Diabetes Centre, Sweden.
authors.forename: Stefan A
authors.initials: SA
authors.lastname: Escher
authors.affiliation: Department of Public Health and Clinical Medicine, Skellefteå Research Unit, Umeå University, Sweden.
authors.forename: Jan-Håkan
authors.initials: JH
authors.lastname: Jansson
mesh_terms: D015992:Body Mass Index; D016022:Case-Control Studies; D016757:Death, Sudden, Cardiac / Q000453:epidemiology / Q000209:etiology*; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000209:etiology*; D016017:Odds Ratio; D010353:Patient Education as Topic; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012308:Risk Management; D012737:Sex Factors; D015996:Survival Rate / Q000639:trends; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors
keywords: Sudden cardiac death; epidemiology; myocardial infarction; prevention; prognosis; risk factors