Table 3.
SCD incidence rate and hazard ratio (95% confidence interval) by echocardiographic variables, ARIC, 1993–2002, and CHS 1989–2002
| Mitral annular calcification | ||||||
|---|---|---|---|---|---|---|
| ARIC | CHS | |||||
|
| ||||||
| No | Yes | p-value | No | Yes | p-value | |
| SCD cases | 37 | 6 | 67 | 91 | ||
| Person-years | 16118 | 796 | 29696 | 20088 | ||
| SCD Incidence rate (95% CI)* | 2.30 (1.64 – 3.13) | 7.54 (3.13 – 15.5) | 2.26 (1.78 – 2.87) | 4.53 (3.69 – 5.56) | ||
| Model 1: HR (95% CI) | 1(REF) | 2.78 (1.16 – 6.63) | 0.02 | 1(REF) | 2.07 (1.50 – 2.85) | <0.001 |
| Model 2: HR (95% CI) | 1(REF) | 2.71 (1.14 – 6.45) | 0.02 | 1(REF) | 2.07 (1.51 – 2.84) | <0.001 |
| Model 3: HR (95% CI) | 1(REF) | 2.56 (1.08 – 6.09) | 0.03 | 1(REF) | 2.07 (1.51 – 2.85) | <0.001 |
| Model 4: HR (95% CI) | 1(REF) | 1.78 (0.73 – 4.35) | 0.20 | 1(REF) | 1.86 (1.34 – 2.58) | <0.001 |
|
| ||||||
| Aortic Sclerosis | ||||||
| ARIC | CHS | |||||
|
| ||||||
| No | Yes | p-value | No | Yes | p-value | |
|
| ||||||
| SCD cases | 37 | 6 | 78 | 74 | ||
| Person-years | 16041 | 879 | 27318 | 21277 | ||
| SCD Incidence rate (95% CI)* | 2.31 (1.65 – 3.14) | 6.83 (2.84 – 14.07) | 2.86 (2.29 – 3.57) | 3.48 (2.77 – 4.37) | ||
| Model 1: HR (95% CI) | 1(REF) | 2.29 (0.95 – 5.51) | 0.06 | 1(REF) | 1.21 (0.88 – 1.67) | 0.25 |
| Model 2: HR (95% CI) | 1(REF) | 2.40 (1.01 – 5.72) | 0.05 | 1(REF) | 1.27 (0.93 – 1.75) | 0.14 |
| Model 3: HR (95% CI) | 1(REF) | 2.16 (0.90 – 5.16) | 0.08 | 1(REF) | 1.28 (0.93 – 1.76) | 0.13 |
| Model 4: HR (95% CI) | 1(REF) | 1.88 (0.78 – 4.53) | 0.16 | 1(REF) | 1.09 (0.79 – 1.53) | 0.59 |
|
| ||||||
| Reduced LV ejection fraction | ||||||
| ARIC | CHS | |||||
|
| ||||||
| No | Yes | p-value | No | Yes | p-value | |
|
| ||||||
| SCD cases | 36 | 7 | 208 | 67 | ||
| Person-years | 16629 | 341 | 58667 | 4143 | ||
| SCD Incidence rate (95% CI)* | 2.16 (1.54 – 2.96) | 20.53 (9.15 – 40.31) | 3.55 (3.10 – 4.06) | 16.17 (12.7 – 20.6) | ||
| Model 1: HR (95% CI) | 1(REF) | 8.13 (3.56 – 18.56) | <0.0001 | 1(REF) | 3.89 (2.93 – 5.16) | <0.001 |
| Model 2: HR (95% CI) | 1(REF) | 5.06 (2.06 – 12.45) | 0.0004 | 1(REF) | 3.26 (2.44 – 4.37) | <0.001 |
| Model 3: HR (95% CI) | 1(REF) | 4.25 (1.70 – 10.63) | 0.002 | 1(REF) | 3.24 (2.42 – 4.33) | <0.001 |
| Model 4: HR (95% CI) | 1(REF) | 1.95 (0.76 – 4.98) | 0.16 | 1(REF) | 3.22 (2.37 – 4.37) | <0.001 |
| Left atrium diameter | ||||||
|---|---|---|---|---|---|---|
| ARIC tertiles (cm) | CHS tertiles (cm) | |||||
|
| ||||||
| <3.62 | 3.62 – 4.05 | >4.05 | <3.60 | 3.60 – 4.13 | >4.13 | |
| SCD cases | 9 | 9 | 17 | 71 | 80 | 112 |
| Person-years | 4580 | 4572 | 4634 | 20881 | 20997 | 19032 |
| SCD Incidence rate (95% CI)* | 1.97 (0.97 – 3.59) | 1.97 (0.97 – 3.59) | 3.67 (2.22 – 5.74) | 3.40 (2.70 – 4.29) | 3.81 (3.06 – 4.74) | 5.89 (4.89 – 7.08) |
| Model 1: HR (95% CI) | 1 (ref.) | 1.00 (0.40 – 2.52) | 1.81 (0.81 – 4.07) | 1 (ref.) | 1.05 (0.77 – 1.45) | 1.46 (1.08 – 1.98) |
| Model 2: HR (95% CI) | 1 (ref.) | 0.97 (0.38 – 2.44) | 1.50 (0.69 – 3.54) | 1 (ref.) | 1.03 (0.75 – 1.42) | 1.34 (0.99 – 1.81) |
| Model 3: HR (95% CI) | 1 (ref.) | 0.93 (0.65 – 3.37) | 1.48 (0.65 – 3.37) | 1 (ref.) | 1.03 (0.75 – 1.41) | 1.33 (0.98 – 1.80) |
| Model 4: HR (95% CI) | 1 (ref.) | 0.91 (0.36 – 2.41) | 1.40 (0.61 – 3.21) | 1 (ref.) | 1.06 (0.76 – 1.48) | 1.27 (0.92 – 1.74) |
| Aortic root diameter | ||||||
|---|---|---|---|---|---|---|
| Aric tertiles (cm) | CHS tertiles (cm) | |||||
|
| ||||||
| <2.92 | 2.92 – 3.29 | >3.29 | <2.96 | 2.96 – 3.35 | >3.35 | |
| SCD cases | 8 | 12 | 22 | 73 | 81 | 110 |
| Person-years | 5195 | 4984 | 5146 | 21487 | 20747 | 18791 |
| SCD Incidence rate (95% CI)* | 1.54 (0.73 – 2.91) | 2.41 (1.31 – 4.08) | 4.28 (2.76 – 6.36) | 3.40 (2.70 – 4.27) | 3.90 (3.14 – 4.85) | 5.85 (4.86 – 7.06) |
| Model 1: HR (95% CI) | 1 (ref.) | 1.43 (0.58 – 3.53) | 2.34 (0.97 – 5.62) | 1 (ref.) | 0.94 (0.68 – 1.30) | 1.01 (0.72 – 1.42) |
| Model 2: HR (95% CI) | 1 (ref.) | 1.42 (0.58 – 3.49) | 2.59 (1.15 – 5.84) | 1 (ref.) | 0.98 (0.72 – 1.35) | 1.23 (0.90 – 1.68) |
| Model 3: HR (95% CI) | 1 (ref.) | 1.38 (0.56 – 3.38) | 2.41 (1.06 – 5.45) | 1 (ref.) | 0.98 (0.71 – 1.35) | 1.21 (0.89 – 1.66) |
| Model 4: HR (95% CI) | 1 (ref.) | 1.34 (0.55 – 3.29) | 2.12 (0.92 – 4.85) | 1 (ref.) | 0.99 (0.71 – 1.37) | 1.13 (0.82 – 1.57) |
| LV mass index | ||||||
|---|---|---|---|---|---|---|
| ARIC tertiles (g/m^2.7) | CHS tertiles (g/m^2.7) | |||||
|
| ||||||
| <41.4 | 41.4 – 53.1 | >53.1 | <33.07 | 33.07 – 42.20 | >42.20 | |
| SCD cases | 7 | 9 | 16 | 36 | 51 | 79 |
| Person-years | 4278 | 4318 | 4327 | 15391 | 15002 | 13197 |
| SCD Incidence rate (95% CI)* | 1.64 (0.73 – 3.21) | 2.08 (1.03 – 3.80) | 3.70 (2.20 – 5.86) | 2.34 (1.69 – 3.24) | 3.40 (2.58 – 4.47) | 5.99 (4.80 – 7.46) |
| Model 1: HR (95% CI) | 1 (ref.) | 1.24 (0.46 – 3.34) | 2.09 (0.86 – 5.09) | 1 (ref.) | 1.48 (0.96 – 2.26) | 2.41 (1.62 – 3.58) |
| Model 2: HR (95% CI) | 1 (ref.) | 1.12 (0.41 – 3.01) | 1.58 (0.62 – 4.01) | 1 (ref.) | 1.38 (0.90 – 2.12) | 2.02 (1.35 – 3.01) |
| Model 3: HR (95% CI) | 1 (ref.) | 1.11 (0.41 – 2.99) | 1.49 (0.58 – 3.79) | 1 (ref.) | 1.39 (0.91 – 2.14) | 2.03 (1.36 – 3.02) |
| Model 4: HR (95% CI) | 1 (ref.) | 1.21 (0.45 – 3.26) | 1.40 (0.56 – 3.54) | 1 (ref.) | 1.26 (0.81 – 1.96) | 1.69 (1.12 – 2.58) |
| Mitral E to A | ||||||
|---|---|---|---|---|---|---|
| ARIC (m/s) | CHS (m/s) | |||||
|
| ||||||
| <0.70 | 0.70 – 1.5 | >1.5 | <0.70 | 0.70 – 1.5 | >1.5 | |
| SCD cases | 5 | 30 | 3 | 71 | 170 | 23 |
| Person-years | 1270 | 13294 | 1030 | 10106 | 47698 | 3170 |
| SCD Incidence rate (95% CI)* | 3.94 (1.49 – 8.63) | 2.26 (1.55 – 3.18) | 2.91 (0.81 – 7.77) | 7.03 (5.57 – 8.87) | 3.56 (3.07 – 4.14) | 7.26 (4.82 – 10.92) |
| Model 1: HR (95% CI) | 1.40 (0.43 – 4.71) | 1 (ref.) | 1.43 (0.43 – 4.71) | 1.84 (1.39 – 2.46) | 1 (ref.) | 1.94 (1.25 – 3.00) |
| Model 2: HR (95% CI) | 1.15 (0.42 – 3.11) | 1 (ref.) | 1.35 (0.41 – 4.49) | 1.84 (1.39 – 2.44) | 1 (ref.) | 1.82 (1.18 – 2.83) |
| Model 3: HR (95% CI) | 0.97 (0.36 – 2.66) | 1 (ref.) | 1.42 (0.43 – 4.69) | 1.81 (1.37 – 2.40) | 1 (ref.) | 1.78 (1.15 – 2.77) |
| Model 4: HR (95% CI) | 0.24 (0.08 – 0.73) | 1 (ref.) | 0.91 (0.33 – 2.56) | 1.73 (1.29 – 2.32) | 1 (ref.) | 1.85 (1.16 – 2.96) |
| Mitral Peak E | ||||
|---|---|---|---|---|
| ARIC (m/s) | CHS (m/s) | |||
|
| ||||
| Continuous, per 1 SD | p-value+ | Continuous, per 1 SD | p-value+ | |
| Model 1: HR (95% CI) | 1.49 (1.14 – 1.96) | 0.004 | 1.11 (0.98 – 1.26) | 0.09 |
| Model 2: HR (95% CI) | 1.37 (1.06 – 1.77) | 0.02 | 1.04 (0.92 – 1.17) | 0.55 |
| Model 3: HR (95% CI) | 1.39 (1.08 – 1.79) | 0.01 | 1.04 (0.92 – 1.18) | 0.52 |
| Model 4: HR (95% CI) | 1.29 (1.01 – 1.66) | 0.04 | 1.04 (0.92 – 1.18) | 0.51 |
ARIC=Atherosclerosis Risk in Communities Study; CHD=coronary heart disease; CHS=Cardiovascular Health Study; CVD=cardiovascular disease; eGFR=estimated glomerular filtration rate; HDLc=high density lipoprotein cholesterol; LV=left ventricular; SCD=sudden cardiac death
*
Crude incidence rates per 1000 person-years
Refer to Supplemental Table 2 for continuous variable data.
Model 1: Cox proportional hazards model adjusted for age, sex, **race (in CHS only)
Model 2: Cox proportional hazards model adjusting for Framingham risk score as one variable: (sex, age, total cholesterol, HDLc, blood pressure, diabetes and smoking), and also prevalent CHD
Model 3: Model 2 + eGFR
Model 4: Model 3 + time-dependent heart failure, time-dependent CHD