Sudden cardiac arrest related to coronary artery disease in young adults

Background Considering major shifts in coronary artery disease (CAD) epidemiology over the last two decades, we hypothesized that CAD was probably henceforth the main etiology of sudden cardiac arrest (SCA) among young adults. Purpose To describe burden and features of CAD-related SCA in young (≤ 40 year-old) adults using a contemporary community-based study. Methods From May 2011 to 2016, all cases of SCA admitted alive across 48 hospitals of the Greater Paris Area were prospectively enrolled and young SCA ( Results Out of 18,662 out-of-hospital cardiac arrests, 3028 SCA were admitted alive, with 353 (11.7%) being ≤ 40 year-old (32.1 ± 6.2 year-old, 70.8% males). Among the 1,557 (51.4%) patients with an established cardiac cause, 142 (9.1%) were aged less than 40-years. CAD accounted for 58 (40.8%) cases, whereas non-ischemic heart disease and non-structural heart disease for 52 (36.6%) and 32 (22.5%), respectively. Within the 30–40 year age group, CAD represented 53.7% of all diagnoses. While 86.2% of CAD-related young SCA was due to an acute coronary syndrome (ACS), rate of immediate coronary angiography at hospital admission was only 39.2% compared to 63.4% among those > 40-years (OR = 0.38, 95% CI: 0.27–0.53, P P Fig. 1 ). Conclusions CAD is a major cause of SCA in young adults, representing > 50% of SCAs occurring in the fourth decade. With ACS representing the major part of these events, the observed low rates of immediate coronary angiography suggest an important missed opportunity for early intervention.