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

  • Lynge TH & al.
  • Eur Heart J
  • 17 Dec 2019

  • International Clinical Digest
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

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.