ARE WOMEN WITH MINIMAL TO MILD CORONARY ARTERY DISEASE AT HIGHER RISK OF SUDDEN CARDIAC DEATH THAN MEN?

Abstract

Therapeutic Area: ASCD/CVD in Women Background: Despite considerable advancements in identifying and treating cardiac ailments, sudden cardiac death (SCD) continues to be a critical global health concern. Coronary artery disease (CAD) is the leading cause of SCD in both genders, with SCD frequently being the initial indication of underlying CAD in females. As a result, we urgently need to improve our analysis of the risk factors and mechanisms of SCD in female patients. Methods: Our study examined post-mortem data from 221 cases of sudden death. Of these, 165 were categorized as sudden cardiac death (53 female and 112 male), while the rest were classified as non-cardiac-related sudden death. SCD was defined as non-traumatic, unexpected circulatory arrest occurring within one hour of the onset of symptoms in an asymptomatic subject. We gathered demographic information and clinical conditions, including age, race, gender, BMI, family history of SCD, hypertension, heart failure, CAD, obesity, prior revascularization, location of arrest, and presence of an ICD. The CAD-RADS system was used to study minimal to mild CAD. Statistical significance was set at p < 0.05. Results: Based on our extensive analysis of 221 individuals, we found that 75% of deaths were linked to cardiac-related issues, with the remaining 25% attributed to non-cardiac factors. Our research revealed that women with mild to minimal CAD were at a higher risk of SCD (P<0.002) than men (P<0.02). Interestingly, we also discovered that septal fibrosis carried an equal risk of SCD for both genders. It's worth noting that women who experienced cardiac-related deaths showed higher levels of septal and left ventricular fibrosis with reduced EF compared to those who died due to non-cardiac-related factors. Conclusions: It is crucial to recognize that a considerable number of women who experience sudden cardiac death may have had minimal to mild coronary heart disease in the past. Our research findings indicate that untreated CAD may be a significant contributor to SCD in women. Therefore, it is essential to investigate and prevent the underlying factors of CAD. Medical practitioners should prioritize preventive measures, such as early identification of mild and insignificant CAD in women, promoting strict management of hypertension, diabetes, and hyperlipidemia, and monitoring BMI during routine check-ups. Future studies may investigate additional ways to prevent ventricular wall fibrosis.