Abstract P237: Common Genetic Variation in Caspase Enzymes and Survival of Sudden Cardiac Arrest

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Catherine O Johnson ◽  
Rozenn N Lemaitre ◽  
Nona Sotoodehnia ◽  
Barbara McKnight ◽  
Kenneth M Rice ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Genetic Variation ◽  
Hospital Admission ◽  
Hospital Discharge ◽  
A Priori ◽  
Sudden Cardiac Arrest ◽  
Population Based ◽  
Minor Allele ◽  
P Value ◽  
Brain Resuscitation

Background: Reperfusion following ischemia due to sudden cardiac arrest (SCA) is necessary for survival, but results in additional injury to affected tissues. Regulation of apoptosis has been shown to be important in determining the extent of reperfusion injury. Caspases (CASP) are essential enzymes in the apoptotic cascade and we therefore hypothesized that genetic variation in these enzymes might influence cardiac and brain resuscitation after SCA. To test this, we examined three genes (CASP2, CASP3, CASP9) in a population-based study of SCA survival. Methods: Subjects (mean age 67, 80% male, of European descent) were out-of-hospital SCA patients found in ventricular fibrillation (VF) and attended by paramedics in King County, WA (n=1614). To investigate cardiac resuscitation, we compared subjects who survived to hospital admission (n=827) with those who did not (n=787); for brain resuscitation, we compared subjects who survived to hospital discharge (n=448) with those who did not (n=1166). Associations of 19 SNPs were examined using logistic regression comparing each additional copy of the minor allele. Based on a priori hypotheses, models were adjusted for: age; gender; time from 911 call to arrival of emergency medical services; whether the event was witnessed; occurred in public; and whether bystander CPR was administered. We used within-gene permutation tests to adjust p-values for multiple comparisons. Results: Two SNPs in CASP3 were associated with SCA survival. The A allele of rs4647688 (minor allele frequency (MAF) 0.20) was associated with lower rates of survival to hospital admission (OR (95% CI), adjusted p-value: 0.78 (0.65, 0.93), p =0.043). The T allele of rs2705897 (MAF 0.26) was associated with a higher rate of survival to hospital admission (1.27 (1.07, 1.51), p =0.049). These two SNPs are in almost complete linkage equilibrium (r 2 =0.091). No SNPs in CASP3 were significantly associated with survival to hospital discharge, and no SNPs in CASP2 or CASP9 were significantly associated with either outcome. Conclusions: CASP3 variants are associated with SCA survival in this population. Further work is needed to explore the effect of these variants on regulation of apoptosis during reperfusion following VF arrest, and to replicate these findings in other populations.

Abstract P119: Erythrocyte n-3 and n-6 Polyunsaturated and Trans Fatty Acids and Survival of Sudden Cardiac Arrest

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Rozenn N Lemaitre ◽  
Irena B King ◽  
Catherine O Johnson ◽  
Nona Sotoodehnia ◽  
Barbara McKnight ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Cardiac Arrest ◽  
Arachidonic Acid ◽  
Fatty Acid ◽  
Hospital Admission ◽  
Hospital Discharge ◽  
Trans Fatty Acid ◽  
Trans Fatty Acids ◽  
P Value ◽  
Brain Resuscitation

Lower levels of erythrocyte n-3 polyunsaturated fatty acid (PUFA) and higher levels of trans-fatty acid are associated with incident cardiac arrest (SCA) risk. However, it is not known whether these fatty acids also influence post-arrest survival. In addition, n-3 and n-6 PUFA play key roles in brain function and may be involved in brain resuscitation. We investigated the association of n-3, n-6 and trans-fatty acid levels with resuscitation outcomes in a population-based study of SCA. Subjects (mean age 68, 82% male) were out-of-hospital SCA patients found in ventricular fibrillation and attended by paramedics in King County, Washington, with available fatty acid measurements (n=492). Using logistic regression, we examined association between fatty acid levels and surviving to hospital admission (a proxy for heart resuscitation), and also to surviving to hospital discharge (a proxy for brain resuscitation). Both analyses adjusted for age; sex; race; year of cardiac arrest; time to arrival of emergency medical services; whether the event was witnessed, occurred in public, and whether bystander CPR was administered. Levels of arachidonic acid and trans-18:2 fatty acids were associated with SCA survival ( Table ). An increase of one SD in levels of arachidonic acid was associated with decreased likelihood of survival to both hospital admission and hospital discharge (OR (95% CI), uncorrected p-value: 0.75 (0.62-0.92), p =0.006 and 0.69 (0.55, 0.87), p =0.002, respectively). A one SD difference in trans-18:2 fatty acid levels was associated with decreased likelihood of survival to hospital discharge (0.74 (0.57-0.96), p =0.02)). Levels of n-3 PUFAs and trans-18:1 fatty acids were not associated with SCA survival. Our findings suggest arachidonic acid and trans-18:2 may influence SCA survival. Further work is needed to explore the role of fatty acid metabolism in heart and brain resuscitation. Association of Erythrocyte Fatty Acids with Resuscitation Outcomes Survival to hospital admission Survival to hospital discharge OR * (95% CI) p-value OR * (95% CI) p-value n-3 fatty acids α-Linolenic acid 1.01 (0.83-1.22) 0.95 0.85 (0.67-1.07) 0.60 EPA+DHA 1.05 (0.87-1.28) 0.60 1.10 (0.87-1.38) 0.44 n-6 fatty acids Linoleic acid 0.97 (0.80-1.18) 0.77 1.05 (0.83-1.33) 0.66 Arachidonic acid 0.75 (0.62-0.92) 0.006 0.69 (0.55-0.87) 0.002 Trans-fatty acids Trans-18:1 1.06 (0.87-1.29) 0.56 1.06 (0.84-1.34) 0.47 Trans-18:2 0.99 (0.80-1.22) 0.93 0.74 (0.57-0.96) 0.02 * OR corresponding to one SD higher levels

scholarly journals 156 Prehospital determinants of successful resuscitation after traumatic and non-traumatic out-of-hospital cardiac arrest

2020 ◽  
Vol 37 (12) ◽  
pp. 825.1-825
Author(s):  
Ed Barnard ◽  
Daniel Sandbach ◽  
Tracy Nicholls ◽  
Alastair Wilson ◽  
Ari Ercole
Keyword(s):  
Overall Survival ◽  
Cardiac Arrest ◽  
Hospital Admission ◽  
Hospital Discharge ◽  
Multivariable Analysis ◽  
Discharge Data ◽  
Successful Resuscitation ◽  
Bystander Cpr ◽  
Number Percentage ◽  
Hospital Cardiac Arrest

Aims/Objectives/BackgroundOut-of-hospital cardiac arrest (OHCA) is prevalent in the UK. Reported survival is lower than in countries with comparable healthcare systems; a better understanding of outcome determinants may identify areas for improvement. Aim: to compare differential determinants of survival to hospital admission and survival to hospital discharge for traumatic (TCA) and non-traumatic cardiac arrest (NCTA).Methods/DesignAn analysis of 9109 OHCA in East of England between 1 January 2015 and 31 July 2017. Univariate descriptives and multivariable analysis were used to understand the determinants of survival for NTCA and TCA. Two Utstein outcome variables were used: survival to hospital admission and hospital discharge. Data reported as number (percentage), number (percentage (95% CI)) and median (IQR) as appropriate. Continuous data have been analysed with a Mann-Whitney U test, and categorical data have been analysed with a χ2 test. Analyses were performed using the R statistical programming language.Results/ConclusionsThe incidence of OHCA was 55.1 per 100 000 population/year. The overall survival to hospital admission was 27.6% (95%CI 26.7% to 28.6%) and the overall survival to discharge was 7.9% (95%CI 7.3% to 8.5%). Survival to hospital admission and survival to hospital discharge were both greater in the NTCA group compared with the TCA group: 27.9% vs 19.3% p=0.001, and 8.0% vs 3.8% p=0.012 respectively.Determinants of NTCA and TCA survival were different, and varied according to the outcome examined. In NTCA, bystander cardiopulmonary resuscitation (CPR) was associated with survival at discharge but not at admission, and the likelihood of bystander-CPR was dependent on geographical socioeconomic status.NTCA and TCA are clinically distinct entities with different predictors for outcome and should be reported separately. Determinants of survival to hospital admission and discharge differ in a way that likely reflects the determinants of neurological injury. Bystander CPR public engagement may be best focused in more deprived areas.

Abstract 12069: Long-Term Trends in the Incidence and Outcome of Refractory and Non-Refractory Ventricular Fibrillation Cardiac Arrest

Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Ziad Nehme ◽  
Emily Andrew ◽  
Jocasta Ball ◽  
Karen L Smith
Keyword(s):  
Cardiac Arrest ◽  
Ventricular Fibrillation ◽  
Hospital Discharge ◽  
Temporal Trends ◽  
Developed Countries ◽  
Population Based ◽  
Logistic Regression Models ◽  
Shockable Rhythm ◽  
Adjusted Logistic Regression ◽  
Population Based Registry

Introduction: Although many developed countries are reporting temporal improvements in out-of-hospital cardiac arrest (OHCA) outcomes from initial shockable rhythms, trends in the incidence and outcome of refractory ventricular fibrillation are not well understood. Methods: Between 2010 and 2019, we performed a retrospective observational study of OHCA from a population-based registry in Victoria, Australia. We included all adult, non-traumatic OHCA with an initial shockable rhythm. Temporal trends in incidence and survival to hospital discharge were compared across non-refractory and refractory OHCA, defined as cases receiving 3 or more consecutive shocks for a persistent shockable rhythm. Risk-adjusted logistic regression models were used to describe the year-on-year change in the likelihood of refractory OHCA and survival to hospital discharge. Results: Of the 7,267 initial shockable OHCA with an attempted resuscitation, 4168 (57.4%) and 3,099 (42.6%) were non-refractory and refractory OHCA, respectively. The proportion of cases with refractory OHCA declined over the study period from 48.4% in 2010 to 40.2% in 2019 (p trend <0.001). Unadjusted survival to hospital discharge was higher in non-refractory OHCA (46.3% vs. 25.8%, p<0.001), although both populations experienced increases in survival over time (p trend <0.05 for both). After adjustment for arrest confounders, the likelihood of refractory VF decreased by 4.4% every year (adjusted odds ratio [AOR]: 0.96, 95% CI: 0.94, 0.97; p<0.001). Factors reducing the likelihood of refractory OHCA were female sex, bystander CPR, arrest witnessed by emergency medical services, and public location. In the survival model, refractory OHCA was independently associated with a reduction in survival to hospital discharge (AOR 0.50, 95% CI: 0.45, 0.56; p<0.001). Temporal improvements in survival were observed year-on-year (AOR 1.03, 95% CI: 1.02, 1.05; p<0.001) and this did not differ between non-refractory and refractory OHCA (group interaction, p = 0.51). Conclusions: The incidence of refractory OHCA is declining in our region and survival outcomes are improving. Further research identifying factors contributing to the decline in refractory OHCA may help to improve outcomes further.

Abstract 13027: Risk of Sudden Cardiac Arrest According to the Time of STEMI Occurrence: the e-MUST Study

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Nicole Karam ◽  
Sophie Bataille ◽  
Muriel Tafflet ◽  
Eloi Marijon ◽  
Jean Philippe Empana ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Hospital Admission ◽  
Sudden Cardiac Arrest ◽  
Progressive Increase ◽  
Time Interval ◽  
Main Mode ◽  
Time Intervals ◽  
Circadian Change ◽  
Hospital Study ◽  
Suspected Acute Myocardial Infarction

Introduction: STEMI mortality decreased drastically during the last decades, and out-of-hospital sudden cardiac arrest (SCA) has become its main mode of death. The risk of out-of-hospital SCA according to the timing of STEMI occurrence has not been assessed. Hypothesis: The risk of SCA, prior to hospital admission, differs according to the timing of STEMI occurrence. Methods: Data were taken from a prospective pre-hospital study (e-MUST study) on all STEMI patients managed by emergency medical services in Paris and its suburbs between January 2006 and December 2010. In this area, emergency calls are routed to the closest dispatch center and regulated by physicians who send, in the field, an ambulance with a physician on board in case of suspected acute myocardial infarction. Pre-hospital EKGs are obtained for all patients and those presenting STEMI are included in the study. We assessed the rate of SCA, prior to hospital admission, according to the timing of STEMI occurrence (4 hours-time intervals starting at midnight). Results: Among the 8,112 STEMI patients enrolled (mean age (SD) 61.6 (14.3) years, 78% males), 452 patients (5.6%) developed out-of-hospital SCA. We observed significant circadian change in the rate of SCA per STEMI, with a progressive increase between 4am and 8pm, followed by a decrease between 8pm and 4am (P=0.0009). The peak rate of SCA per STEMI occurred in the 4pm-8pm time interval (7.7%), while the lowest rate was seen between 4am and 8am (4.2%) (Figure). Conclusions: The risk of STEMI-related SCA is almost 2-fold higher in STEMI occurring in the late afternoon hours. A better understanding of patients’ characteristics, circumstances of occurrence, and pre-hospital care is needed to eventually reduce the risk of SCA promptly after STEMI diagnosis in the field.

P6471Pronostic impact of significant valvular disease in long-term survivors of out-of-hospital-cardiac arrest

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
L Rodriguez ◽  
J Caro-Codon ◽  
J R Rey-Blas ◽  
S O Rosillo ◽  
O Gonzalez ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiac Arrest ◽  
Hospital Discharge ◽  
Percutaneous Treatment ◽  
Valvular Disease ◽  
Temperature Management ◽  
P Value ◽  
Coronary Syndrome ◽  
Hospital Cardiac Arrest

Abstract Background There is scarce evidence about the prevalence and clinical relevance of moderate to severe valvular heart disease (VHD) in survivors of out of hospital cardiac arrest (OHCA). Purpose To determine whether VHD influence prognosis of OHCA survivors. Methods All consecutive patients admitted to the Acute Cardiac Care Unit after OHCA and surviving until hospital discharge were included. All patients received targeted-temperature management according to our local protocol. Univariate and multivariate Cox-proportional hazard models were employed. Results A total of 201 patients were included in the analysis. Mean age was 57.6±14.2 years and 168 (83.6%) were male. Eighteen patients (9.0%) had moderate or severe VHD during index admission (Table 1). Patients with VHD were less frequently of male sex, [11 (61.1%) vs 157 (85.8%), p=0.014], experienced less acute coronary syndrome-related arrhytmias [2 (11.1%) vs 85 (46.5%), p=0.005], and had a lower pH at hospital admission (6.9±1.6 vs 7.2±0.15, p=0.008). During a median follow-up of 40.3 (18.9–69.1) months, patients with VHD showed higher mortality [7 (38.9%) vs 28 (15.3%), p=0.004] and more heart failure-related admissions [7 (38.9%) vs 15 (8.2%), p<0.001]. Only five patients received surgical or percutaneous treatment for VHD during follow-up, with no deaths in this subgroup. Moderate or severe VHD proved to be an independent predictor of global cardiovascular events and specifically heart failure episodes (Figure 1). Table1 Variable With valvular disease Without valvular disease p value Age, mean±DS, years 63.5±13.2 57.0±14.1 0.066 Hypertension, n (%) 12 (66.7) 95 (51.9) 0.231 Diabetes, n (%) 5 (27.8) 24 (13.1) 0.149 Dyslipidaemia, n (%) 7 (38.9) 79 (43.2) 0.726 Smokin habit, n (%) 4 (22.2) 90 (49.2) 0.045 Witnessed cardiac arrest, n (%) 18 (100) 175 (95.6) 1.000 Time from CA to ROSC, mean±DS, minute 19.1±7.5 21.2±13.1 0.506 Shockable rhythm, n (%) 13 (72.2) 163 (89.1) 0.055 LVEF at hospital discharge (%) 42.8±12.1 46.9±14.6 0.254 Figure 1 Conclusion The presence of significant VHD in survivors after OHCA is a predictor of poor outcomes. Specific management of VHD may be specially relevant in this high-risk patients and guideline-oriented therapy, including surgery and percutaneous intervention should be encouraged when indicated.

scholarly journals Circulating n-3 fatty acids and trans-fatty acids, PLA2G2A gene variation and sudden cardiac arrest

2016 ◽  
Vol 5 ◽  
Author(s):  
Rozenn N. Lemaitre ◽  
Traci M. Bartz ◽  
Irena B. King ◽  
Jennifer A. Brody ◽  
Barbara McKnight ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Cardiac Arrest ◽  
Fatty Acid ◽  
Metabolic Pathways ◽  
Genetic Factors ◽  
Statistical Significance ◽  
Sudden Cardiac Arrest ◽  
Population Based ◽  
Gene Variation ◽  
Total Fatty Acids

AbstractWhether genetic factors influence the associations of fatty acids with the risk of sudden cardiac arrest (SCA) is largely unknown. To investigate possible gene–fatty acid interactions on SCA risk, we used a case-only approach and measured fatty acids in erythrocyte samples from 1869 SCA cases in a population-based repository with genetic data. We selected 191 SNP in ENCODE-identified regulatory regions of fifty-five candidate genes in fatty acid metabolic pathways. Using linear regression and additive genetic models, we investigated the association of the selected SNP with erythrocyte levels of fatty acids, including DHA, EPA and trans-fatty acids among the SCA cases. The assumption of no association in non-cases was supported by analysis of publicly available datasets containing over 8000 samples. None of the SNP–fatty acid associations tested among the cases reached statistical significance after correction for multiple comparisons. One SNP, rs4654990 near PLA2G2A, with an allele frequency of 0·33, was nominally associated with lower levels of DHA and EPA and higher levels of trans-fatty acids. The strongest association was with DHA levels (exponentiated coefficient for one unit (1 % of total fatty acids), 0·90, 95 % CI 0·85, 0·97; P = 0·003), indicating that for subjects with a coded allele, the OR of SCA associated with one unit higher DHA is about 90 % what it is for subjects with one fewer coded allele. These findings suggest that the associations of circulating n-3 and trans-fatty acids with SCA risk may be more pronounced in carriers of the rs4654990 G allele.

scholarly journals Risk of out-of-hospital cardiac arrest among sepsis survivors in Taiwan: analysis of a nationwide population-based cohort

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e051502
Author(s):  
Wan-Ting Hsu ◽  
Charles Fox Sherrod ◽  
Babak Tehrani ◽  
Alexa Papaila ◽  
Lorenzo Porta ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Hospital Discharge ◽  
Cox Regression ◽  
Population Based ◽  
National Database ◽  
Secondary Outcome ◽  
Research Database ◽  
Increased Risk ◽  
Matching Techniques ◽  
Hospital Cardiac Arrest

ObjectivesThere is minimal literature examining the association of sepsis with out-of-hospital cardiac arrest (OHCA). Using a large national database, we aimed to quantify the risk of OHCA among sepsis patients after hospital discharge.DesignPopulation-based cohort study.SettingNationwide sepsis cohort retrieved from the National Health Insurance Research Database of Taiwan between 2000 and 2013.ParticipantsWe included 17 304 patients with sepsis. After hospital discharge, 144 patients developed OHCA within 30 days and 640 between days 31 and 365.Primary and secondary outcome measuresThe main outcomes were OHCA events following hospital discharge for sepsis. To evaluate the independent association between sepsis and OHCA after a sepsis hospitalisation, we constructed two non-sepsis comparison cohorts using risk set sampling and propensity score matching techniques (non-infection cohort, non-sepsis infection cohort). We plotted the daily number and daily risk of OHCA within 1 year of hospital discharge between sepsis and matched non-sepsis cohorts. We used Cox regression to evaluate the risk of early and late OHCA, comparing sepsis to non-sepsis patients.ResultsCompared with non-infected patients, sepsis patients had a higher rate of early (HR 1.66, 95% CI: 1.27 to 2.16) and late (HR 1.19, 95% CI: 1.06 to 1.33) OHCA events. This association was independent of age, sex or cardiovascular history. Compared with non-sepsis patients with infections, sepsis patients had a higher rate of both early (HR 1.28, 95% CI: 1.00 to 1.63) and late (HR 1.13, 95% CI: 1.01 to 1.27) OHCA events, especially among patients with cardiovascular disease (OR 1.35, 95% CI: 1.01 to 1.81).ConclusionsSepsis patients had increased risk of OHCA compared with matched non-sepsis controls, which lasted up to 1 year after hospital discharge.

scholarly journals Higher chances of survival to hospital admission after out-of-hospital cardiac arrest in patients with previously diagnosed heart disease

Open Heart ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. e001805
Author(s):  
Laura Helena van Dongen ◽  
Marieke T Blom ◽  
Sandra C M de Haas ◽  
Henk C P M van Weert ◽  
Petra Elders ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Heart Disease ◽  
Hospital Admission ◽  
Hospital Discharge ◽  
Lower Proportion ◽  
Initial Rhythm ◽  
Multivariable Regression ◽  
Medical Histories ◽  
Underlying Mechanisms ◽  
Hospital Cardiac Arrest

AimThis study aimed to determine whether patients suffering from out-of-hospital cardiac arrest (OHCA) with a pre-OHCA diagnosis of heart disease have higher survival chances than patients without such a diagnosis and to explore possible underlying mechanisms.MethodsA retrospective cohort study in 3760 OHCA patients from the Netherlands (2010–2016) was performed. Information from emergency medical services, treating hospitals, general practitioner, resuscitation ECGs and civil registry was used to assess medical histories and the presence of pre-OHCA diagnosis of heart disease. We used multivariable regression analysis to calculate associations with survival to hospital admission or discharge, immediate causes of OHCA (acute myocardial infarction (AMI) vs non-AMI) and initial recorded rhythm.ResultsOverall, 48.1% of OHCA patients had pre-OHCA heart disease. These patients had higher odds to survive to hospital admission than patients without pre-OHCA heart disease (OR 1.25 (95%CI 1.05 to 1.47)), despite being older and more often having cardiovascular risk factors and some non-cardiac comorbidities. These patients also had higher odds of shockable initial rhythm (SIR) (OR 1.60 (1. 36 to 1.89)) and a lower odds of AMI as immediate cause of OHCA (OR 0.33 (0.25 to 0.42)). Their chances of survival to hospital discharge were not significantly larger (OR 1.16 (0.95 to 1.42)).ConclusionHaving pre-OHCA diagnosed heart disease is associated with better odds to survive to hospital admission, but not to hospital discharge. This is associated with higher odds of a SIR and in a subgroup with available diagnosis a lower proportion of AMI as immediate cause of OHCA.

Abstract 17127: Sports-Related Sudden Cardiac Arrest: Comparison of Survival Outcomes in Europe versus the United States

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Eloi Marijon ◽  
Audrey Uy-Evanado ◽  
Florence Dumas ◽  
Carmen Teodeorescu ◽  
Kyndaron Reinier ◽  
...  
Keyword(s):  
United States ◽  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Response Times ◽  
Survival Rates ◽  
Sudden Cardiac Arrest ◽  
The United States ◽  
Population Based ◽  
Sports Activity ◽  
Bystander Cardiopulmonary Resuscitation

Background: Sports-related sudden cardiac arrest (sport SCA) has always attracted attention and the United States and European Union have developed divergent strategies for prevention over the last decade; notably regarding screening of younger athletes but also for SCA prevention in middle-aged and senior individuals. In this context, the extent to which outcomes of sports SCA differ between Europe and the USA have not been characterized. Methods: SCA cases aged 15-75 years were identified in two large prospective, population-based SCA programs, one in the Paris region (Paris-SDEC) and the other in a Northwestern US metro region (Oregon-SUDS) between 2002 and 2012. Cases of SCA, occurring during sports activity were compared between the two regions. Results: Of the 7,357 cases studied, 290 (4%) occurred during sports, with very similar proportions in both regions: 86 out of 1,894 (4.5%) in Oregon and 204 out of 5,463 (3.8%) in Paris. Subjects’ characteristics of cases in both programs were very similar (Paris vs. Oregon, respectively, for all results following), regarding age (50.7±14 vs. 50.4±13 years, P=0.55), male proportion (94%vs. 92%, P=0.53), past medical history of ≥2 cardiovascular risk factors (16% vs. 23%, P=0.16) and/or heart disease (10% vs. 8%, P=0.55). There was a high proportion of witnessed events in both populations (89% vs. 90%, P=0.94). However, we observed significant differences with more bystander cardiopulmonary resuscitation in Paris (63% vs. 48%, P=0.02), faster response time in Oregon (8.3±6 vs. 6.9±4 min, P=0.05), and more initially shockable rhythms in Oregon (52% vs. 70%, P=0.006). Overall, resuscitation outcomes were very similar for return of spontaneous circulation (26% vs. 33%, P=0.21) and survival to hospital discharge (27% vs. 26%, P=0.80). Conclusions: On either side of the Atlantic, burden and characteristics of sports-related SCA are very similar. Survival rates are approximately one in four cases. Optimizing bystander cardiopulmonary resuscitation rates and emergency response times could further improve outcomes. Deployment of uniform, effective strategies for screening and prevention are likely to make the greatest impact on sports SCA.

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