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The incidence and definition of sudden cardiac death (SCD) and sudden cardiac arrest (SCA) in the United States are poorly understood, requiring a standardised definition of both and ongoing research efforts to examine cases more broadly across communities, say the authors of a report1 published recently in the Journal of the American College of Cardiology.

To find estimates of the incidence of SCA and/or SCD, the authors performed a systematic literature search in MEDLINE using relevant keywords.  35 full-length, peer-reviewed, publications were selected for full review, which yielded 6 studies providing primary data used to derive an estimated annual incidence of SCD in the US.

Due to differing data sources and stated definitions of SCA and/or SCD, which varied across the 6 studies, the estimated annual incidence of SCD contained in these studies ranged from 180,000 to >450,000.  The authors claim that this variation highlights “the lack of clarity about the true annual incidence of SCA and/or SCD in the U.S.,” while also reflecting “inconsistencies in the medical community’s knowledge and understanding of SCD”.

The authors assert that the ability to reliably estimate the incidence of SCA and/or SCD in the U.S. is essential for preventing SCD, improving risk stratification techniques, and directing future research that may save lives. On the basis of their findings, they recommend 3 “actionable next steps”:

1. Establish precise, uniform definitions of SCA and of SCD, to be agreed upon and adopted by the major stakeholders in the medical/scientific community.

2. Perform larger, multicenter, prospective studies in the general population as well as across different geographic regions and races, using the above definitions to facilitate optimal case ascertainment.

3. Integrate multiple source methods for case ascertainment to capture more cases and rule out those cases that do not meet strict criteria according to the definitions determined above.


1 Kong MH, Fonarow GC, Peterson ED, et al. Viewpoint: Systematic Review of the Incidence of Sudden Cardiac Death in the United States.  J Am Coll Cardiol 2011;57:794-801.

Published on: May 6, 2011

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