Table 3.
Autopsy-Defined Causes of Presumed SCDs by Race.
| Asian (N=110) | Black (81) | Hispanic (40) | White (279) | ||||
|---|---|---|---|---|---|---|---|
| Autopsy-Defined SAD | 68 (62%) | p* = NS | 35 (43%) | p* = NS | 21 (53%) | p* = NS | 160 (57%) |
| All CAD | 38 (35%) | NS | 15 (19%) | .03 | 11 (28%) | NS | 98 (35%) |
| Acute CAD | 14 (13%) | NS | 5 (6%) | NS | 2 (5%) | NS | 31 (11%) |
| Chronic CAD | 24 (22%) | NS | 10 (12%) | NS | 9 (23%) | NS | 67 (24%) |
| Cardiomyopathy | 9 (8%) | NS | 12 (15%) | NS | 3 (8%) | NS | 27 (10%) |
| Hypertrophy | 11 (10%) | NS | 7 (9%) | NS | 3 (8%) | NS | 23 (8%) |
| Primary Electrical Disease | 1 (1%) | NS | 0 (0%) | NS | 3 (8%) | .03 | 3 (1%) |
| MINOCA | 5 (5%) | .04 | 1 (1%) | NS | 0 (0%) | NS | 1 (0.4%) |
| Other† | 4 (4%) | NS | 0 (0%) | NS | 1 (3%) | NS | 8 (3%) |
| Cardiac, Non-Arrhythmic | 6 (5%) | NS | 1 (1%) | NS | 0 (0%) | NS | 12 (4%) |
| Acute MI w/ Rupture | 6 (5%) | NS | 0 (0%) | NS | 0 (0%) | NS | 6 (2%) |
| Acute MI w/ Pump Failure | 0 (0%) | NS | 1 (1%) | NS | 0 (0%) | NS | 1 (0.4%) |
| Chronic Heart Failure | 0 (0%) | NS | 0 (0%) | NS | 0 (0%) | NS | 4 (1%) |
| Pericarditis | 0 (0%) | NS | 0 (0%) | NS | 0 (0%) | NS | 1 (0.4%) |
| Non-Cardiac | 36 (33%) | NS | 45 (56%) | .04 | 19 (47%) | NS | 107 (39%) |
| Acute Renal Failure | 0 (0%) | NS | 1 (1%) | NS | 1 (3%) | NS | 3 (1%) |
| Aortic Dissection | 4 (4%) | NS | 0 (0%) | NS | 2 (5%) | NS | 8 (3%) |
| Aspiration/Asphyxia | 2 (2%) | NS | 0 (0%) | NS | 1 (3%) | NS | 2 (1%) |
| Occult Overdose | 5 (5%) | 0.01 | 18 (22%) | NS | 4 (10%) | NS | 44 (16%) |
| GI Hemorrhage/Other GI‡ | 2 (2%) | NS | 3 (4%) | NS | 4 (10%) | .01 | 6 (2%) |
| Hypo/Hyperglycemia/DKA | 1 (1%) | NS | 5 (6%) | .02 | 0 (0%) | NS | 3 (1%) |
| Infection | 5 (5%) | NS | 5 (6%) | NS | 3 (8%) | NS | 9 (3%) |
| Neurologic | 11 (10%) | .02 | 5 (6%) | NS | 3 (8%) | NS | 10 (4%) |
| Pulmonary Embolism | 1 (1%) | NS | 6 (7%) | NS | 0 (0%) | NS | 12 (4%) |
| Other Non-Cardiac§ | 5 (5%) | NS | 2 (2%) | NS | 1 (3%) | NS | 10 (4%) |
CAD indicates coronary artery disease; DKA, diabetic ketoacidosis; GI, gastrointestinal; MI, myocardial infarction; MINOCA, myocardial infarction without obstructive coronary arteries; SAD, sudden arrhythmic death; SCD, sudden cardiac death
Autopsy etiologies of SAD and presumed SCDs by race after review of comprehensive medical records, EMS run sheets, and systematic autopsy data including postmortem chemistry and toxicology. All p-values are for comparison to White subjects. Cardiomyopathy (CM) included non-ischemic/dilated, drug/alcohol-induced, non-compaction CM, stress CM, ARVD, HIV-CM, and amyloidosis. Hypertrophy as determined by histology included hypertensive heart disease, hypertrophic cardiomyopathy (HCM), and unspecified.
Adjusted for age and sex vs. reference White
Other cardiac arrhythmic causes included acquired long QT syndrome (LQTS), bicuspid aortic valve, MI with non-obstructive coronary arteries (MINOCA), cardiac implantable external device (CIED) concern and/or failure, mitral valve prolapse, and critical aortic stenosis (AS).
Other GI causes included incarcerated/strangulated hernia, bowel obstruction, hepatorenal failure/pancreatitis, and liver failure.
Other non-cardiac causes included acute alcohol withdrawal, disseminated cancer, hypothermia, liver failure, other hemorrhage/trauma, end-stage chronic obstructive pulmonary disease (COPD), obstructive sleep apnea (OSA), aortic aneurysm rupture, renal artery dissection, iliac artery dissection, and pulmonary artery dissection.