Chronic kidney disease was the strongest risk factor for sudden cardiac arrest among Hispanic and Latino adults in the first study to evaluate this population in the U.S. for risk factors of this major cause of death.
Researchers from Cedars–Sinai Medical Center in Los Angeles identified clinical predictors that influence out-of-hospital sudden cardiac arrest (SCA) — an emergency in which the heart stops beating that affects 350,000 individuals in the United States annually. They found that more than half the SCA patients in the study, published Wednesday in the Journal of the American Heart Association, had chronic kidney disease.
Historically, Hispanic and Latino individuals have been underrepresented in cardiovascular disease research. “Sudden cardiac arrest is a major cause of death, yet little is known about risk factors for SCA among Hispanic and Latino individuals, who make up about 19% of the U.S. population,” said Kyndaron Reinier, associate director for epidemiology in the Center for Cardiac Arrest Prevention at the Smidt Heart Institute of Cedars-Sinai, and the paper’s lead author.
In this case-control study comparing 295 Hispanic or Latino adults who had a sudden cardiac arrest to a matched control group of Hispanic or Latino adults who did not, 51% of the sudden cardiac arrest cases had a prior diagnosis of chronic kidney disease, with 20% of those cases experiencing end-stage kidney disease requiring dialysis.
Sumeet Chugh, a professor of cardiology at Cedars-Sinai and another author, called for further research to examine why chronic kidney disease patients face an increased risk of sudden cardiac arrest. “While more research needs to be done, it is possible that dialysis treatment, which is used in severe or end-stage CKD, could be associated with increased risk of lethal arrhythmias resulting in SCA,” he said. “It turns out that even moderate CKD could increase SCA risk, but the mechanisms by which this happens have not been determined yet.”
Previous studies have suggested that the progression of chronic kidney disease to complete kidney failure occurs rapidly among Hispanics and Latinos. This may be due to lower access to care, including dietary counseling, dialysis, and kidney transplantation among this population, said Chugh.
The new research has some limitations. First, the study included Hispanic/Latino individuals living in Southern California who were of mostly Mexican heritage; therefore, results may not apply to people living in other regions of the country or to all Hispanic/Latino people. Moreover, there may be some unmeasured differences between the case and control groups that were not accounted for.
Still, the paper highlights the need for early identification and management of kidney disease, as it may reduce the risk of sudden cardiac arrest among Hispanic/Latino people, researchers suggest. “It’s worth noting that the patients with cardiac arrest in this study are relatively young (low 60s) which is a reminder of the devastating toll of cardiac arrest in communities,” said Jason H. Wasfy, an associate professor at Harvard Medical School and cardiologist at Mass General Brigham, who was not involved with the study.
Wasfy said the study shows the importance of equitable access to screening and prevention services, especially in communities of color. “These results suggest that the burden of this devastating syndrome needs to be addressed with multiple public health efforts, including prevention and management of risk factors as well as strengthening awareness and infrastructure of systems of care to better respond when patients do have cardiac arrest,” he said.