ObjectiveTo determine the association between serum lipid measurements and the occurrence of out-of-hospital sudden unexpected death (OHSUD).Patients and MethodsWe compared 139 OHSUD cases (43 female patients [30.9%]) and 968 controls (539 female patients [55.7%]) from Wake County, North Carolina, from March 1, 2013, through February 28, 2015. Individuals were included if they were aged 18 to 64 years and had lipid measurements in the 5 years before their death (cases) or the most recent health care encounter (controls). Covariates were abstracted from medical records for all subjects, and those with triglyceride (TG) levels greater than 400 mg/dL (to convert to mmol/L, multiply by 0.0259) were excluded for low-density lipoprotein (LDL)–related analyses.ResultsBy linear regression using age- and sex-adjusted models, cases of OHSUD had lower adjusted mean total cholesterol (170.3±52.2 mg/dL vs 188.9±39.7 mg/dL; P<.001), LDL cholesterol (90.9±39.6 mg/dL vs 109.6±35.2 mg/dL; P<.001), and non–high-density lipoprotein (HDL) (121.6±49.8 mg/dL vs 134.3±39.6 mg/dL; P<.001) levels and a higher adjusted TG/HDL-C ratio (4.7±7 vs 3±2.7; P<.001) than did controls. By logistic regression using age- and sex-adjusted models, the odds of OHSUD were elevated per unit increase in TG/HDL-C ratio (1.08; 95% CI, 1.03-1.12).ConclusionOut-of-hospital sudden unexpected death cases had more favorable levels of total cholesterol, LDL cholesterol, and non-HDL, possibly indicating a lack of association between traditional lipid cardiovascular risk factors and sudden unexpected death. A comparatively elevated TG/HDL-C ratio in cases may corroborate an evolving hypothesis of how vasoactive and prothrombotic remnant-like lipoprotein particles contribute to sudden unexpected death.

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In this report, applicant types are sometimes combined into a smaller number of groups.  Foreign-Trained Physicians: U.S. citizen and non-U.S. citizen students and graduates of international medical schools.  Independent Applicants (IA): All applicant categories excluding U.S. allopathic seniors.  Others: Includes previous U.S. graduates and Canadian, Osteopathic, and Fifth Pathway applicants. Couple Any two applicants can register as a couple in the Match. The NRMP allows couples to form pairs of choices on their primary rank order lists, which are considered in rank order when the matching algorithm is processed. The couple will match to the most preferred pair of programs where each partner has been offered a position. PGY-1 & PGY-2 Postgraduate year one and postgraduate year two. Program Type The NRMP classifies programs for the Main Residency Match into five types:  Advanced (A) programs: Programs that begin in the PGY-2 year after a year of prerequisite training.  Categorical (C) programs: Programs that begin in the PGY-1 year and provide the full training required for specialty board certification.  Primary (M) programs: Categorical programs in primary care medicine and primary care pediatrics that begin in the PGY-1 year and provide the full training required for specialty board certification.  Preliminary (P) programs: One-year programs that begin in the PGY-1 year and provide prerequisite training for advanced programs.  Physician (R) programs: Programs that are reserved for physicians who have had prior graduate medical education. Reserved programs offer PGY-2 positions that begin in the year of the Match and thus are not available to senior medical students. SOAP The Supplemental Offer and Acceptance Program® (SOAP®) is a process by which eligible unmatched applicants in the Main Residency Match apply for and are offered positions that did not fill when the matching algorithm was processed. vi Results and Data 2017 Main Residency Match® Position Fill Rate A successful Match is measured not just by volume, but also by how well it matches the preferences of applicants and program directors. Based on that criterion, the overall position fill rate of 96.0 percent makes the 2017 Match one of the most successful on record. After the matching algorithm was processed, only 1,279 of the 31,757 positions were unfilled and 1,177 of those positions were placed in the Match Week Supplemental Offer and Acceptance Program (SOAP). At the conclusion of SOAP, all but 101 were filled, for a post-SOAP fill rate of 99.4 percent.