Sudden cardiac death risk is greatly increased among young people with diabetes

  • Lynge TH & al.
  • Eur Heart J
  • 17.12.2019

  • von Miriam Tucker
  • Clinical Essentials
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Takeaway

  • Sudden cardiac death (SCD) rate is almost 9-fold greater among people ages 1-35 years with diabetes vs those without it.

Why this matters

  • Diabetes is a well-established risk factor for SCD.

Study design

  • Danish databases, 1363 SCD cases identified, 2000-2009.
  • Among the 14,294 who died, 5% (669) had diabetes, of whom 118 had SCD (9% of all SCD).
  • Funding: Novo Nordisk Foundation.

Key results

  • With diabetes:
    • Less frequent medicolegal external examinations: 50% vs 76% without diabetes; and 
    • Less frequent autopsies: 32% vs 57% (both P<.001>
  • Among those ages 1-35 years, age- and sex-standardized SCD incidence rates (IRs) per 100,000 person-years were:
    • 21.9 (95% CI, 14.9-72.5) with diabetes vs
    • 2.6 (95% CI, 2.4-2.8) without;
    • IR ratio 8.6 (95% CI, 5.8-28.6).
  • For ages 36-49 years, SCD IRs per 100,000 person-years were:
    • 119.8 (95% CI, 93.7-152.1) with diabetes vs 
    • 19.7 (95% CI, 18.2-21.2);
    • IR ratio, 6.1 (95% CI, 4.7-7.8).
  • SCD IR ratios with vs without type 1 diabetes were:
    • 9.9 (95% CI, 6.3-30) for ages 1-35 years, and
    • 9.2 (95% CI, 6.6-12.7) for ages 36-49 years.
  • For type 2, those numbers were:
    • 6.1 (95% CI, 2.2-34.5) for ages 21-35 years, and
    • 4.7 (95% CI, 3.2-6.9) for ages 36-49 years.

Limitations

  • Retrospective.
  • Most nonautopsied cases assumed to be cardiac-related.
  • No laboratory, lifestyle data.