Diabetes and the risk of sudden cardiac death, the Atherosclerosis Risk in Communities study

Anna M. Kucharska-Newton, David J. Couper, James S. Pankow, Ronald J. Prineas, Thomas D. Rea, Nona Sotoodehnia, Aravinda Chakravarti, Aaron R. Folsom, David S. Siscovick, Wayne D. Rosamond

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62 Scopus citations


Studies suggest that diabetes may specifically elevate the risk of sudden cardiac death in excess of other heart disease outcomes. In this study, we examined the association of type 2 diabetes with the incidence of sudden cardiac death when compared to the incidence of non-sudden cardiac death and non-fatal myocardial infarction (MI). We used data from the Atherosclerosis Risk in Communities (ARIC) study to examine the incidence of sudden and non-sudden cardiac death and non-fatal MI among persons with and without diabetes in follow-up from the baseline data collection (1987-1989) through December 31, 2001. There were 209 cases of sudden cardiac death, 119 of non-sudden cardiac death, and 739 of non-fatal MI identified in this cohort over an average 12.4 years of follow-up. In analyses adjusted for age, race/ARIC center, gender, and smoking, the Cox proportional hazard ratio of the association of baseline diabetes was 3.77 (95% CI 2.82, 5.05) for sudden cardiac death, 3.78 (95% CI 2.57, 5.53) for non-sudden cardiac death, and 3.20 (95% CI 2.71, 3.78) for non-fatal MI. Elevated risk for each of the three outcomes associated with diabetes was independent of adjustment for measures of blood pressure, lipids, inflammation, hemostasis, and renal function. Among those with diabetes, the risk of cardiac death, but not of non-fatal MI, was similar for men and women. Findings from this prospective, population-based cohort investigation indicate that diabetes does not confer a specific excess risk of sudden cardiac death. Our results suggest that diabetes attenuates gender differences in the risk of fatal cardiac events.

Original languageEnglish
Pages (from-to)S161-S168
JournalActa Diabetologica
Issue numberSUPPL. 1
StatePublished - Dec 2010

Bibliographical note

Funding Information:
The authors thank the staff and participants of the ARIC study for their important contributions. The Atherosclerosis Risk in Communities Study is carried out as a collaborative study supported by National Heart, Lung, and Blood Institute contracts N01-HC-55015; N01-HC-55016; N01-HC-55018; N01-HC-55019; N01-HC-55020; N01-HC-55021; and N01-HC-55022. This work was also supported by a National Research Service Award training grant T32 H2-0007055 [to AMK-N].


  • Cohort study
  • Coronary heart disease
  • Diabetes
  • Myocardial infarction
  • Sudden cardiac death

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology


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