Coronary artery disease underlies most sports-related sudden cardiac arrest in the general population

AbstractBackgroundAnomalous aortic origin of a coronary artery is the second leading cause of sudden cardiac arrest/death in young athletes in the United States of America. Limited data are available regarding family history in this patient population.MethodsPatients were evaluated prospectively from 12/2012 to 02/2017 in the Coronary Anomalies Program at Texas Children’s Hospital. Relevant family history included the presence of CHD, sudden cardiac arrest/death, arrhythmia/pacemaker use, cardiomyopathy, and atherosclerotic coronary artery disease before the age of 50 years. The presence of one or more of these in 1st- or 2nd-degree relatives was considered significant.ResultsOf 168 unrelated probands (171 patients total) included, 36 (21%) had significant family history involving 19 (53%) 1st-degree and 17 (47%) 2nd-degree relatives. Positive family history led to cardiology referral in nine (5%) patients and the presence of abnormal tests/symptoms in the remaining patients. Coronary anomalies in probands with positive family history were anomalous right (27), anomalous left (five), single right coronary artery (two), myocardial bridge (one), and anomalous circumflex coronary artery (one). Conditions present in their family members included sudden cardiac arrest/death (15, 42%), atherosclerotic coronary artery disease (14, 39%), cardiomyopathy (12, 33%), CHD (11, 31%), coronary anomalies (3, 8%), myocardial bridge (1, 3%), long-QT syndrome (2, 6%), and Wolff–Parkinson–White (1, 3%).ConclusionIn patients with anomalous aortic origin of a coronary artery and/or myocardial bridges, there appears to be familial clustering of cardiac diseases in approximately 20% of patients, half of these with early occurrence of sudden cardiac arrest/death in the family.

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Syncope and risk of sudden cardiac arrest in coronary artery disease

International Journal of Cardiology ◽

10.1016/j.ijcard.2016.12.021 ◽

2017 ◽

Vol 231 ◽

pp. 26-30 ◽

Cited By ~ 7

Author(s):

Aapo L. Aro ◽

Carmen Rusinaru ◽

Audrey Uy-Evanado ◽

Kyndaron Reinier ◽

Derek Phan ◽

...

Keyword(s):

Coronary Artery Disease ◽

Cardiac Arrest ◽

Coronary Artery ◽

Sudden Cardiac Arrest ◽

Artery Disease

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Electrocardiographic Predictors of Out-of-Hospital Sudden Cardiac Arrest in Patients With Coronary Artery Disease

The American Journal of Cardiology ◽

10.1016/j.amjcard.2011.12.020 ◽

2012 ◽

Vol 109 (9) ◽

pp. 1278-1282 ◽

Cited By ~ 9

Author(s):

Miguel E. Lemmert ◽

Jacqueline J.M. de Vreede-Swagemakers ◽

Luc W.M. Eurlings ◽

Luc Kalb ◽

Harry J.G.M. Crijns ◽

...

Keyword(s):

Coronary Artery Disease ◽

Cardiac Arrest ◽

Coronary Artery ◽

Sudden Cardiac Arrest ◽

Artery Disease

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Angiographic characteristics and long-term prognostic impact of coronary artery disease in survivors after sudden cardiac arrest with a non-diagnostic electrocardiogram

Catheterization and Cardiovascular Interventions ◽

10.1002/ccd.27713 ◽

2018 ◽

Vol 93 (1) ◽

pp. 9-15 ◽

Cited By ~ 1

Author(s):

María Teresa Nogales-Romo ◽

Carlos Ferrera ◽

Pablo Salinas ◽

Pedro Martínez-Losas ◽

Luis Nombela-Franco ◽

...

Keyword(s):

Coronary Artery Disease ◽

Cardiac Arrest ◽

Coronary Artery ◽

Sudden Cardiac Arrest ◽

Prognostic Impact ◽

Artery Disease

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Abstract 347: Sudden Cardiac Arrest Caused by Coronary Artery Disease in School Students

Circulation ◽

10.1161/circ.140.suppl_2.347 ◽

2019 ◽

Vol 140 (Suppl_2) ◽

Author(s):

Mamoru Ayusawa ◽

Masataka Kato ◽

Akiko Komori ◽

Yuriko Abe ◽

Rie Ichikawa

Keyword(s):

Coronary Artery Disease ◽

Cardiac Arrest ◽

Coronary Artery ◽

Junior High ◽

Sudden Cardiac Arrest ◽

Intensity Level ◽

Mutual Aid ◽

School Students ◽

Long Distance ◽

Artery Disease

Background: To disclose coronary artery disease (CAD) in the young is difficult by electrocardiogram screening for school students before their first events. Methods: By reviewing all reports submitted to the Mutual Aid System for Schools between 1989 and 2015, we listed all cases of sudden cardiac arrest which were considered to be caused by CAD. Kawasaki disease sequela was excluded. Epidemiology, type of CAD, symptom before onset, the intensity of the exercise at onset were investigated. Results: Thirty cases were enrolled and 26 resulted in sudden deaths, 4 were resuscitated without unfavorable sequelae. Cardioverter-defibrillator were implanted in 2 cases. Twenty-eight were male. One student was in 6th grader of primary, 11 in junior high, 15 cases in high, and 3 cases in nursing schools. Before onset, 12 cases were diagnosed as normal by ECG screening, 1 case for each was diagnosed as premature ventricular contraction, Wolff-Parkinson-White syndrome, and past history of atrial flutter. Diagnosis of 15 cases was unknown. Types based on hospital or post-mortem records: Left coronary artery (LCA); LCA of two cases were originated from the pulmonary artery, 4 cases from right coronary cuspid (RCC), and 1 from an unknown site. Two cases with LCA malformation without detail description, 3 with left ostium stenosis, and 1 with a myocardial bridge. Right coronary artery (RCA); RCA of a student was from left coronary cuspid (LCC), 1 from unknown site, 4 cases were diagnosed as hypoplastic RCA. Three cases complicated with atherosclerotic stenosis, 2 with hypoplastic CA, a case with single CA, and 4 with vasospastic angina.The school grader at onset: All of 4 cases with LCA from RCC, 2/3 with the LCA ostium stenosis and 3/4 with RCA hypoplasia were junior high school cases. Exercise intensity (level 1 to 5: most strenuous): At the onset, 19 cases were at level 5, 7 at level 4, 1 at level 3, 3 at an unknown level. Exercise at onset; soccer in 6 cases, basketball in 5, long distance running in 4, swimming, baseball, tennis, rugby, kendo, and on the way to school were in 2 for each. Conclusion: Anomalous ostium and origin of CA from the opposite side cusp tend to cause cardiac arrest in younger cases. CA evaluation by CT angiogram, MRI, or myocardial perfusion imaging is desirable.

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GWAS for discovery and replication of genetic loci associated with sudden cardiac arrest in patients with coronary artery disease

BMC Cardiovascular Disorders ◽

10.1186/1471-2261-11-29 ◽

2011 ◽

Vol 11 (1) ◽

Cited By ~ 38

Author(s):

Bradley E Aouizerat ◽

Eric Vittinghoff ◽

Stacy L Musone ◽

Ludmila Pawlikowska ◽

Pui-Yan Kwok ◽

...

Keyword(s):

Coronary Artery Disease ◽

Cardiac Arrest ◽

Coronary Artery ◽

Sudden Cardiac Arrest ◽

Genetic Loci ◽

Artery Disease

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Reversible Cause of Cardiac Arrest and Secondary Prevention Implantable Cardioverter Defibrillators in Patients With Coronary Artery Disease: Value of Complete Revascularization and LGE‐CMR

Journal of the American Heart Association ◽

10.1161/jaha.120.019101 ◽

2021 ◽

Author(s):

Anne‐Lotte C. J. van der Lingen ◽

Marthe A. J. Becker ◽

Michiel J. B. Kemme ◽

Mischa T. Rijnierse ◽

Eva M. Spoormans ◽

...

Keyword(s):

Coronary Artery Disease ◽

Cardiac Arrest ◽

Coronary Artery ◽

Sudden Cardiac Arrest ◽

Left Ventricular ◽

Complete Revascularization ◽

Gadolinium Enhancement ◽

Icd Implantation ◽

Off Label ◽

Artery Disease

Background In survivors of sudden cardiac arrest with obstructive coronary artery disease, it remains challenging to distinguish ischemia as a reversible cause from irreversible scar‐related ventricular arrhythmias. We aimed to evaluate the value of implantable cardioverter‐defibrillator (ICD) implantation in sudden cardiac arrest survivors with presumably reversible ischemia and complete revascularization. Methods and Results This multicenter retrospective cohort study included 276 patients (80% men, age 67±10 years) receiving ICD implantation for secondary prevention. Angiography was performed before ICD implantation. A subgroup of 166 (60%) patients underwent cardiac magnetic resonance imaging with late gadolinium enhancement before implantation. Patients were divided in 2 groups, (1) ICD‐per‐guideline, including 228 patients with incomplete revascularization or left ventricular ejection fraction ≤35%, and (2) ICD‐off‐label, including 48 patients with complete revascularization and left ventricular ejection fraction >35%. The primary outcome was time to appropriate device therapy (ADT). During 4.0 years (interquartile range, 3.5–4.6) of follow‐up, ADT developed in 15% of the ICD‐off‐label group versus 43% of the ICD‐per‐guideline group. Time to ADT was comparable in the ICD‐off‐label and ICD‐per‐guideline groups (hazard ratio (HR), 0.46; P =0.08). No difference in mortality was observed (HR, 0.95; P =0.93). Independent predictors of ADT included age (HR, 1.03; P =0.01), left ventricular end‐diastolic volume HR, (1.05 per 10 mL increase; P <0.01) and extent of transmural late gadolinium enhancement (HR, 1.12; P =0.04). Conclusions This study demonstrates that sudden cardiac arrest survivors with coronary artery disease remain at high risk of recurrent ventricular arrhythmia, even after complete revascularization and with preserved left ventricular function. Late gadolinium enhancement–cardiac magnetic resonance imaging derived left ventricular volumes and extent of myocardial scar were independently associated with.

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Association of CASQ2 polymorphisms with sudden cardiac arrest and heart failure in patients with coronary artery disease

Heart Rhythm ◽

10.1016/j.hrthm.2014.01.015 ◽

2014 ◽

Vol 11 (4) ◽

pp. 646-652 ◽

Cited By ~ 10

Author(s):

Marwan M. Refaat ◽

Bradley E. Aouizerat ◽

Clive R. Pullinger ◽

Mary Malloy ◽

John Kane ◽

...

Keyword(s):

Heart Failure ◽

Coronary Artery Disease ◽

Cardiac Arrest ◽

Coronary Artery ◽

Sudden Cardiac Arrest ◽

Artery Disease

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P4427Cardiovascular outcomes among runners of a marathon race - a 17 years' experience

European Heart Journal ◽

10.1093/eurheartj/ehz745.0829 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

W L Poon ◽

K L Lee ◽

K Chan

Keyword(s):

Coronary Artery Disease ◽

Cardiac Arrest ◽

Coronary Artery ◽

Artery Bypass ◽

Sudden Cardiac Arrest ◽

Pulseless Electrical Activity ◽

Implantable Cardioverter Defibrillators ◽

Coronary Anomaly ◽

Emergency Department Admission ◽

Artery Disease

Abstract Introduction Over the past 17 years (2002–2018), 898,831 people participated in the Hong Kong Standard Chartered Marathon (HKSCM). Purpose We aim to study the incidence of marathon-related sudden cardiac arrest (SCA) and non-fatal myocardial injury (NFMI). Methods All the HKSCM related admissions between 2002 and 2017 were retrieved from the accident and emergency department admission records. We reviewed the data of HKSCM runners admitted for SCA and NFMI. Results Fourteen and thirty-nine runners were admitted for SCA (Mean age 38±13 years-old, 12 men) and NFMI (Mean age 42±12 years-old; 34 men) respectively. Among the SCA runners, the arrest rhythms could not be retrieved in 3 cases. In the remaining 11 SCA runners, the arrest rhythms were ventricular fibrillation (VF) (N=6), pulseless-electrical activity (PEA) (N=3), and asystole (N=2). Nine of the 14 SCA runners were successfully resuscitated. Only 2 out of the 14 SCA runners had significant atherosclerotic coronary artery disease (CAD) requiring coronary angioplasty. Among the SCA runners, the etiologies of cardiac arrest were myocardial infarction (MI) (N=2), ischemic cardiomyopathy with VF (N=1), idiopathic VF (N=3), malignant coronary anomaly (N=1), and idiopathic (N=5). Percutaneous coronary intervention (PCI) was performed in 2 SCA runner with MI. Implantable cardioverter-defibrillators were implanted in 1 resuscitated runner with VF. Postmortem examination of the 3 deceased runners showed significant CAD in two and was unrevealing in one. Among the 39 NFMI runners, coronary angiograms (CAG) or CT coronary angiogram were performed in 14 cases (36%), which showed minor CAD or unremarkable findings in 7 runners, and significant CAD in 7 runners. PCI and coronary artery bypass were performed in 5 and 2 NFMI runners respectively. Only 8 out of 39 NFMI runners reported chest pain. Significant ischemic ECG changes were detected in 9 out of 39 NFMI runners. Invasive CAGs were not performed in the remaining NFMI runners due to low pre-test likelihood of CAD and normal non-invasive test results. Conclusions The incidence of SCA and mortality among HKSCM runners was 1.56 per 100,000 and 0.56 per 100,000 respectively. The incidence of NFMI was 4.3 per 100,000. Coronary artery disease, coronary anomaly and idiopathic VF were the commonest etiologies of SCA.

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