Abstract 13126: Sudden Cardiac Arrest in Asian Americans: Prospective Evaluation in Two US Communities

Background: There is a lack of data on epidemiology of sudden cardiac arrest (SCA) in the Asian-American community. We have recently reported lower annual incidence of SCA in Asian compared to White non-Hispanic residents of Ventura County, CA. However, the generalizability of these findings has not been evaluated.

Hypothesis: We hypothesized that these trends are observed in other US communities.

Methods: An epidemiologic assessment of SCA was performed and compared in Ventura County, CA (2018 Pop 848,112; study period 2015-2021) and Multnomah County, OR (2010 Pop 712,036; study period 2002-2014). All out-of-hospital SCA cases with likely cardiac etiology and resuscitation attempted by emergency medical services (EMS) were prospectively ascertained. We calculated race-specific annual age-adjusted SCA incidence using the US standard population and compared incidence and resuscitation outcomes between Asians and Whites in both counties.

Results: A total of 2084 SCA cases were identified in VC (65% male; mean age 71 ± 16 y) and 4149 in MC (69% male; mean age 63 ±18 y). Asian and White SCA cases were similar by age and sex in both counties (p=0.08). In VC, annual age adjusted incidence per 100,000 was 29.4 in Asians and 36.8 in Whites (p=0.02). In MC, annual age adjusted incidence per 100,000 was 22.8 in Asians and 31.1 in Whites (p=0.002). No significant differences were observed in bystander CPR provision or 911 call response time (p>0.23), but Asians were less likely than Whites to present with shockable rhythm (VF/VT) in both locations (VC 10% vs 26%, p<0.001; MC 36% vs 44%, p=0.07). Survival to hospital discharge following SCA was similar in Asian and White residents in VC (Asians 8.4%, Whites 12%, p=0.25) and MC (Asians 11.9%, Whites 14.1%, p=0.52).

Conclusion: We observed lower annual incidence of SCA among Asians compared to Whites in these two separate and geographically distinct US communities. Emergency response and outcomes of arrest were similar in Asians and Whites, despite a lower presentation with a shockable rhythm among Asians. Further study is required to determine whether lower SCA incidence in Asians is explained by a lower risk factor burden or other factors.