Bringing Critical Race Praxis Into the Study of Electrophysiological Substrate of Sudden Cardiac Death: The ARIC Study

ObjectiveVital exhaustion (VE), a construct defined as lack of energy, increased fatigue and irritability, and feelings of demoralisation, has been associated with cardiovascular events. We sought to examine the relation between VE and sudden cardiac death (SCD) in the Atherosclerosis Risk in Communities (ARIC) Study.MethodsThe ARIC Study is a predominately biracial cohort of men and women, aged 45–64 at baseline, initiated in 1987 through random sampling in four US communities. VE was measured using the Maastricht questionnaire between 1990 and 1992 among 13 923 individuals. Cox proportional hazards models were used to examine the hazard of out-of-hospital SCD across tertiles of VE scores.ResultsThrough 2012, 457 SCD cases, defined as a sudden pulseless condition presumed due to a ventricular tachyarrhythmia in a previously stable individual, were identified in ARIC by physician record review. Adjusting for age, sex and race/centre, participants in the highest VE tertile had an increased risk of SCD (HR 1.48, 95% CI 1.17 to 1.87), but these findings did not remain significant after adjustment for established cardiovascular disease risk factors (HR 0.94, 95% CI 0.73 to 1.20).ConclusionsAmong participants of the ARIC study, VE was not associated with an increased risk for SCD after adjustment for cardiovascular risk factors.

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Carotid Intima‐Media Thickness and the Risk of Sudden Cardiac Death: The ARIC Study and the CHS

Journal of the American Heart Association ◽

10.1161/jaha.120.016981 ◽

2020 ◽

Vol 9 (19) ◽

Author(s):

Takeki Suzuki ◽

Wanmei Wang ◽

Anthony Wilsdon ◽

Kenneth R. Butler ◽

Selcuk Adabag ◽

...

Keyword(s):

Sudden Cardiac Death ◽

Carotid Artery ◽

Common Carotid Artery ◽

Cardiac Death ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Cardiovascular Health Study ◽

Media Thickness ◽

Increased Risk ◽

Aric Study

Background Sudden cardiac death (SCD) is associated with severe coronary heart disease in the great majority of cases. Whether carotid intima‐media thickness (C‐IMT), a known surrogate marker of subclinical atherosclerosis, is associated with risk of SCD in a general population remains unknown. The objective of this study was to investigate the association between C‐IMT and risk of SCD. Methods and Results We examined a total of 20 862 participants: 15 307 participants of the ARIC (Atherosclerosis Risk in Communities) study and 5555 participants of the CHS (Cardiovascular Health Study). C‐IMT and common carotid artery intima‐media thickness was measured at baseline by ultrasound. Presence of plaque was judged by trained readers. Over a median of 23.5 years of follow‐up, 569 participants had SCD (1.81 cases per 1000 person‐years) in the ARIC study. Mean C‐IMT and common carotid artery intima‐media thickness were associated with risk of SCD after adjustment for traditional risk factors and time‐varying adjustors: hazard ratios (HRs) with 95% CIs for fourth versus first quartile were 1.64 (1.15–2.63) and 1.49 (1.05–2.11), respectively. In CHS, 302 participants developed SCD (4.64 cases per 1000 person‐years) over 13.1 years. Maximum C‐IMT was associated with risk of SCD after adjustment: HR (95% CI) for fourth versus first quartile was 1.75 (1.22–2.51). Presence of plaque was associated with 35% increased risk of SCD: HR (95% CI) of 1.37 (1.13–1.67) in the ARIC study and 1.32 (1.04–1.68) in CHS. Conclusions C‐IMT was associated with risk of SCD in 2 biracial community‐based cohorts. C‐IMT may be used as a marker of SCD risk and potentially to initiate early therapeutic interventions to mitigate the risk.

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Does sex modify an association of electrophysiological substrate with sudden cardiac death? The Atherosclerosis Risk in Communities (ARIC) study

Cardiovascular Digital Health Journal ◽

10.1016/j.cvdhj.2020.08.003 ◽

2020 ◽

Vol 1 (2) ◽

pp. 80-88

Author(s):

Stacey J. Howell ◽

David German ◽

Aron Bender ◽

Francis Phan ◽

Srini V. Mukundan ◽

...

Keyword(s):

Sudden Cardiac Death ◽

Cardiac Death ◽

Atherosclerosis Risk In Communities ◽

Atherosclerosis Risk ◽

Aric Study

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Serum magnesium and risk of sudden cardiac death in the Atherosclerosis Risk in Communities (ARIC) Study

American Heart Journal ◽

10.1016/j.ahj.2010.06.012 ◽

2010 ◽

Vol 160 (3) ◽

pp. 464-470 ◽

Cited By ~ 80

Author(s):

James M. Peacock ◽

Tetsuya Ohira ◽

Wendy Post ◽

Nona Sotoodehnia ◽

Wayne Rosamond ◽

...

Keyword(s):

Sudden Cardiac Death ◽

Cardiac Death ◽

Serum Magnesium ◽

Atherosclerosis Risk In Communities ◽

Atherosclerosis Risk ◽

Aric Study

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Abstract P103: Kidney Function and Sudden Cardiac Death in the Community: The Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽

10.1161/circ.131.suppl_1.p103 ◽

2015 ◽

Vol 131 (suppl_1) ◽

Author(s):

Takeki Suzuki ◽

Sunil K Agarwal ◽

Rajat Deo ◽

Nona Sotoodehnia ◽

Morgan Grams ◽

...

Keyword(s):

Sudden Cardiac Death ◽

Kidney Function ◽

Cardiac Death ◽

Cox Regression ◽

Full Spectrum ◽

Atherosclerosis Risk In Communities ◽

Demographic Subgroups ◽

Aric Study

Introduction: Individuals with chronic kidney disease (CKD), particularly those requiring dialysis, are at high risk of sudden cardiac death (SCD). However, data for the full-spectrum of kidney function and SCD risk in the community are sparse. Furthermore, newly developed equations for estimated glomerular filtration rate (eGFR) and novel filtration markers might add further insight to the role of kidney function in SCD. Methods: We investigated the associations of baseline eGFRs using either serum creatinine, cystatin C (CysC), or both (eGFRcr, eGFRcr-cys, and eGFRcys), CysC itself, and β 2 -microglobulin (B2M) with SCD through 2001 among 13,070 blacks and whites participants at the second visit (1990-92) of the community-based ARIC Study. Cox regression models were used to quantify the associations of kidney function and different markers of kidney filtration with SCD after the adjustment for potential confounders. The cohort was divided into 5 groups based on clinical CKD Stages as well as quartiles. Results: Over a median of 11 years of follow-up, 205 participants developed SCD (1.4 cases per 1000 person-years). Low eGFR was independently associated with SCD risk: for example, HR for eGFR 30-44 vs ≥90 ml/min/1.73m 2 was 3.97 (95%CI 1.57-10.03) with eGFRcr; HR 6.96 (3.56-13.61) with eGFRcr-cys; and HR 5.47 (2.97-10.09) with eGFRcys. Of note, when eGFRcr and eGFRcys were included together in a single model, the association was only significant for eGFRcys. When we compared all kidney markers based on their quartiles, B2M demonstrated the strongest association with SCD ( Table ). Qualitatively consistent results were observed across clinical and demographic subgroups. Conclusion: Kidney function was independently and robustly associated with SCD in the community, particularly when CysC or B2M were taken into account as filtration markers. These results may suggest the importance of kidney function for SCD risk evaluation and the value of novel filtration markers beyond eGFRcr in association with SCD.

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