Young relatives of sudden cardiac death individuals at high heart disease risk

Young first- and second-degree relatives of individuals who were victims of sudden cardiac death (SCD) are at a significantly increased risk for developing cardiovascular disease (CVD), research suggests.

Mattis Ranthe (Statens Serum Institut, Copenhagen, Denmark) and team say that the results of their study support the use of autopsies in all cases of young sudden cardiac death and suggest that close relatives of individuals who have died would benefit from screening and preventive treatment.

They found that there were 292 cases of CVD over 11 years of follow-up in the 3073 first- and second-degree relatives of 470 individuals aged 1-35 years who experienced SCD between 2000 and 2006 in Denmark.

The mortality risk for a first- or second-degree relative of an SCD individual varied significantly with age: the standardized incidence ratio (SIR) for relatives younger than 35 years was 3.53 compared with an SIR of 1.59 among those aged 35-60 years and 0.91 among those older than 60 years.

There was no significant association between first- and second-degree relatives in terms of SIR for IHD and cardiomyopathy. However, the SIR for ventricular arrhythmia in first-degree relatives was 19.15 compared with 0 in second-degree relatives.

As reported in the European Health Journal, the SIR for any CVD given an SCD in a first-degree relative was significantly higher than that in a second-degree relative, at 1.49 versus 1.11. First-degree relatives younger than 35 years had a fourfold increase in the risk for any CVD, while second-degree relatives had more than a twofold increased risk.

"If sudden cardiac death has genetic causes then this would suggest that relatives of young SCD victims are at greater risk of heart disease than the general population and would benefit from screening to identify those at risk so that they could be given appropriate preventive treatment," said Ranthe.

"This could save a significant number of lives. However, as far as we are aware, there have been no population-based findings of this kind before, and current knowledge is limited and based on smaller descriptive studies."

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