Sudden Death in the General Population in Okinawa

Tokashiki, Takashi; Muratani, Akemi; Kimura, Yorio; Muratani, Hiromi; Fukiyama, Koshiro

doi:10.1253/jcj.63.37

Cited by 46 publications

(26 citation statements)

References 14 publications

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“…That incidence (15.3%) of unexplained SCD is lower than in the present study (44.1%) and may be because the 2 studies are separated by 16 years and Yoon's study was based on medicolegal autopsy in contrast to our clinical study. In our study, acute or old myocardial infarction was only found in 23 (12.4%) of 186 SCD patients and SCD was unexplained despite extensive examination in 82 (44.1%), which are similar findings to those reported by Tokashiki et al 15 in a study of the general population of Okinawa, Japan; they could not determine the cause of SCD in 53% of cases.…”

Section: Discussionsupporting

confidence: 87%

Clinical Characteristics of Unexplained Sudden Cardiac Death in Korea

et al. 2001

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In Western countries, sudden cardiac death (SCD) is closely related to coronary artery disease, but in Korea the clinical characteristics of SCD are not well determined. Over a 4-year period (June 1995 to May 1999), 186 cases of SCD, ranging in age from 16 to 75 years, were admitted to the Chonnam National University Hospital. In 82 (44.1%) of these, neither symptoms nor evidence of structural heart disease was found and so their clinical characteristics were investigated. There were 66 (80.5%) men and 16 (19.5%) women (male/female ratio = 4.1 : 1). The mean age was 50±14 years: 19 (23.2%) were in their 40s, 21 (25.6%) in their 50s, and 17 (20.7%) in their 60s. The time of circulatory collapse witnessed in 68 cases of SCD showed 2 peaks: between midnight and 03.00 h (n=16, 23.5%) and between 09.00 h and midday (n=15, 22.1%). Unexplained SCD occurred at home in 48 (64.9%) cases and on the street in 12 (16.2%); it occurred during normal daily routine activity in 23 (39.6%) and during sleep in 15 (25.9%). Thirty-three patients (40.2%) experienced various prodromal symptoms, including chest discomfort (n=13, 15.9%) and dyspnea (n=8, 9.8%). The electrocardiogram taken on arrival recorded asystole in 65 (79.3%) and ventricular fibrillation in 17 (20.7%). Idiopathic ventricular fibrillation was diagnosed in 14 (10 men, 4 women; 45±11 years) of 21 patients who recovered spontaneous circulation. Five (6.1%) patients were discharged alive, and an implantable cardioverter-defibrillator was implanted in 2. Unexplained SCD is common in Korea and develops predominantly in middle-aged males around midnight or in the late morning usually with no prodromal symptoms (59.8%). Idiopathic ventricular fibrillation is thought to be one of the important causes. (Jpn Circ J 2001; 65: 18 -22)

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Section: Discussionsupporting

confidence: 87%

Clinical Characteristics of Unexplained Sudden Cardiac Death in Korea

et al. 2001

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“…The mean age (51.8 years) at registration in the present study was older than that in most of the previous hospital‐ or community‐based studies that analyzed participants diagnosed as having ERS or Brugada syndrome 15, 25, 27. Nevertheless, ≈90% of the SCDs were observed in participants aged >40 years 30. With participant age at registration (40–64 years) and the >18‐year follow‐up period, we could cover almost all possible age ranges during which a malignant arrhythmia would occur.…”

Section: Discussionmentioning

confidence: 58%

Long‐Term Prognosis of Brugada‐Type ECG and ECG With Atypical ST‐Segment Elevation in the Right Precordial Leads Over 20 Years: Results From the Circulatory Risk in Communities Study (CIRCS)

Tsuneoka

Takagi

Murakoshi

et al. 2016

JAHA

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BackgroundBrugada syndrome is recognized as being associated with sudden cardiac death; however, the prevalence of non–type 1 Brugada‐type ECG (BrS) or atypical ST‐segment elevation in the right precordial leads (STERP) and the long‐term prognosis for those patients remain unknown.Methods and ResultsWe analyzed standard 12‐lead ECGs of 7178 apparently healthy participants (age range 40–64 years) who underwent health checkups from 1982 to 1986 in the Circulatory Risk in Communities Study, a prospective, large, community‐based cohort study in Japan. ECGs with J point amplitude ≥0.2 mV in the right precordial leads were divided into 3 groups: (1) type 1 BrS, (2) type 2 or 3 BrS (non‐type 1 BrS), and (3) STERP. The others served as the non–ST‐segment elevation group. We identified 8 participants (0.1%) with type1 BrS, 84 (1.2%) with non–type 1 BrS, and 228 (3.2%) with STERP. During a median follow‐up of 18.7 years (133 987.0 person‐years), sudden cardiac death was observed in no participants (0.0%) with type 1 BrS, in 1 (1.2%) with non–type 1 BrS, in 7 (3.1%) with STERP, and in 50 (0.7%) with non–ST‐segment elevation. Participants with STERP had a markedly elevated risk of sudden cardiac death (multivariable hazard ratio 3.9, 95% CI 1.7–9.0).Conclusions STERP was associated with an elevated risk of sudden cardiac death in a middle‐aged population.

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“…2,20,21 Epidemiologic data indicate that structural coronary arterial abnormalities and their consequences cause 80% of the cases of VF or pulseless VT, 2,20,22 dilated and hypertrophic cardiomyopathies account for the second largest proportion of 10-15% 2,20 and other cardiac disorders, such as primary electrical and genetic ion-channel abnormalities, valvular or congenital heart disease, account for only a small proportion. 2,20 Although small-scale studies of sudden cardiac death, such as those involved in the WHO-MONICA project 23,24 or autopsy, 25 have reported that the incidence of sudden cardiac death from acute coronary syndrome is lower among patients with out-of-hospital cardiac arrest in Japan than in Europe and the USA, 3 large-scale Japanese studies that used the Utstein guidelines have demonstrated that cardiac etiology accounted for the largest proportion (>50%) of patients with out-of-hospital cardiac arrest, [13][14][15][16] and the proportion of cases of VF or pulseless VT as the first cardiac rhythm was approximately 10% of thoses who were in cardiac arrest before the arrival of EMS personnel who gave CPR. [13][14][15][16] On the other hand, Nagao et al also used the Utstein guidelines and showed that the proportion of VF or pulseless VT as the first cardiac rhythm was 38% with a mean call-to-scene interval of approximately 5.5 min, 26 and the cause of VF was acute coronary syndrome in 78%, which included the initial angiogram of the acute coronary syndrome related artery that had Thrombolysis in Myocardial Infarction flow grade 0-2 in 77%.…”

Section: Discussionmentioning

confidence: 99%

Incidence of Ventricular Fibrillation in Patients With Out-of-Hospital Cardiac Arrest in Japan Survey of Survivors After Out-of-Hospital Cardiac Arrest in Kanto Area (SOS-KANTO)

Committee¹

2005

Circ J

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Sudden Death in the General Population in Okinawa

Cited by 46 publications

References 14 publications

Clinical Characteristics of Unexplained Sudden Cardiac Death in Korea

Clinical Characteristics of Unexplained Sudden Cardiac Death in Korea

Long‐Term Prognosis of Brugada‐Type ECG and ECG With Atypical ST‐Segment Elevation in the Right Precordial Leads Over 20 Years: Results From the Circulatory Risk in Communities Study (CIRCS)

Incidence of Ventricular Fibrillation in Patients With Out-of-Hospital Cardiac Arrest in Japan Survey of Survivors After Out-of-Hospital Cardiac Arrest in Kanto Area (SOS-KANTO)

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