Arrhythmias & electrophysiologyCohort study
Sudden Cardiac Death and its Relation to Previously Diagnosed or Occult Cardiac Disease at Autopsy
- Prospective cohort study
- countywide
- autopsy-based
- 12-year
Authors' conclusion
In this 12-year countywide postmortem study, two-thirds of community arrhythmic SCDs occurred in individuals without diagnosed disease despite substantial cardiac pathology; half of these "silent" arrhythmic deaths had occult MI or DCM.
Study context
- Population
- Presumed sudden cardiac death (SCDs) meeting WHO criteria in a countywide community (POST SCD)513 arrhythmic deaths
- Participants
- 877 participants
- Exposure
- Arrhythmic SCDs with diagnosed RFs vs occult myocardial infarction (MI) or dilated cardiomyopathy (DCM) vs neither; trauma deaths as reference
- Diagnosed RFsn = 166
- Occult MI or DCMn = 159
- Remaining arrhythmic deathsn = 185
- Outcome
- Sensitivity (prevalence) of diagnosed RFs for autopsy-defined arrhythmic death
Main finding
As reported in the abstract
Distribution of autopsy-defined arrhythmic deaths
| Outcome | Diagnosed RFs | Occult MI or DCM | Remaining arrhythmic deaths | Trauma deaths |
|---|---|---|---|---|
| Distribution of autopsy-defined arrhythmic deaths | 32% | 31% | 36% | |
| Mean age | 64.3 years | 62.6 years | 56.9 years | Not reported in the abstract |
| Men | 77% | 80% | Not reported in the abstract | Not reported in the abstract |
- Sensitivity of diagnosed RFs for arrhythmic death
- 32%
- Autopsy-defined arrhythmic deaths among presumed SCDs
- 513 (58%)
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| Cardiac pathology: remaining arrhythmic deaths vs trauma deaths — Remaining arrhythmic deaths vs Trauma deaths · heart weight Z-score 0.9 vs 0.0 | P < 0.001 |
| Cardiac pathology: remaining arrhythmic deaths vs trauma deaths — Remaining arrhythmic deaths vs Trauma deaths · LV diameter 2.5 cm vs 1.9 cm | P < 0.001 |
| Cardiac pathology: remaining arrhythmic deaths vs trauma deaths — Remaining arrhythmic deaths vs Trauma deaths · significant coronary disease 52% vs 13% | P < 0.001 |
- Cardiac pathology: remaining arrhythmic deaths vs trauma deaths — Similar fibrosis
- 6.7% vs 6.3%
- Cardiac pathology: remaining arrhythmic deaths vs trauma deaths — Similar LV hypertrophy burden
- 57% vs 55%
- Cardiac pathology: remaining arrhythmic deaths vs trauma deaths: all P < 0.001
Original publication
Sudden Cardiac Death and its Relation to Previously Diagnosed or Occult Cardiac Disease at Autopsy. J Am Coll Cardiol. Published 23 April 2026. doi:10.1016/j.jacc.2026.01.029
Summarised from the published abstract; every number is checked against it