Community-Based Evaluation of Sudden Cardiac Death in Hispanics/Latinos

项目描述 心脏骤停（SCA）是一种突然的灾难性脉搏丧失，在美国每年影响超过35万人， a >90%的死亡率。因此，改进初级预防是一个主要优先事项。SCA负担受以下因素影响 种族，社会经济地位，以及潜在的种族。西班牙裔/拉丁裔（HL）是最大和最迅速的 越来越多的美国少数民族，但没有前瞻性研究SCA在这个亚组。我们进行了1年（2015年） 在加利福尼亚州文图拉县所有居民中进行的SCA前瞻性初步研究（ 多种族社区，PRESTO，由PI创建），人口分布为42.3% HL（>89% 墨西哥裔）和48.7%的非西班牙裔白色（NHW）。在临床特征上有显著差异 HL（n=71）vs. NHW（n=204）。我们的试验数据还表明了HL中SCA的其他独特方面，特别是 和肥胖的作用。这项建议的总体目标是确定具体的族裔 改进SCA预测和预防的目标。西班牙裔社区健康研究/拉丁裔研究 (HCHS/SOL）是一项由NIH资助的多中心队列研究，纳入了16，000例HL患者，包括4000例 受试者从南加州（圣地亚哥）招募。俄勒冈州意外猝死研究（SUDS）是一项 基于社区的评价持续了16年以上（也是由PI创立）。我们建议 一方面，比较PRESTO HL SCA病例和圣地亚哥HCHS/SOL受试者;以及 另一方面，PRESTO NHW SCA案例和洛杉矶数据存储库（LADR）NHW控制之间存在差异。作为 最后一步，我们将尝试在单独的俄勒冈州SUDS中验证上述分析的结果， 提供访问HL亚组（约76%墨西哥血统），NHW和所有相同的信息。鉴于缺乏 HL SCA的流行病学数据，以及HL和NHW之间临床特征的重要差异 在我们的试点研究中发现的SCA病例，应评估种族特异性SCA风险预测。虽然我们的 结果可能无法推广到所有美国HL人群，我们相信我们的研究将提供有价值的数据 主要是墨西哥血统。利用Ventura PRESTO的既定业绩记录和资源， HCHS/SOL和俄勒冈州SUDS最大限度地提高了实现这一目标的可能性。

Project Description Sudden cardiac arrest (SCA), a sudden catastrophic loss of the pulse, affects >350,000 in the US annually with a >90% mortality rate. Therefore, improved primary prevention is a major priority. SCA burden is affected by race, socioeconomic status, and potentially ethnicity. Hispanics/Latinos (HL) are the largest and most rapidly growing US minority, but there are no prospective studies of SCA in this subgroup. We performed a 1-yr (2015) prospective pilot study of SCA among all residents of Ventura County, CA (PREdiction of Sudden death in mulTi-ethnic cOmmunities, PRESTO, founded by the PI), with a population distribution of 42.3% HL (>89% Mexican origin) and 48.7% non-Hispanic white (NHW). There were significant differences in the clinical profile of HL (n=71) vs. NHW (n=204). Our pilot data also indicated other unique aspects of SCA in HL, specifically related to women, and the role of obesity. The overall goal of this proposal is to identify ethnicity-specific targets for improved SCA prediction and prevention. The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) is an NIH-funded multi-center cohort study of 16,000 persons of HL origin including 4000 subjects recruited from southern CA (San Diego). The Oregon Sudden Unexpected Death Study (SUDS) is a community-based evaluation ongoing for >16 years (also founded by the PI). We propose to make comparisons between PRESTO HL SCA cases and San Diego HCHS/SOL subjects on the one hand; and between PRESTO NHW SCA cases and Los Angeles Data Repository (LADR) NHW controls, on the other. As a final step, we will attempt to validate our findings from the above analysis in the separate Oregon SUDS, that provides access to an HL subgroup (~76% Mexican origin), NHW and all the same information. Given the lack of epidemiologic data on HL SCA, as well as the important differences in clinical profile between HL and NHW SCA cases identified in our pilot study, ethnicity-specific SCA risk prediction should be evaluated. While our results may not be generalizable to all US HL populations, we believe our study would provide valuable data for HL of primarily Mexican origin. Leveraging the established track record and resources of Ventura PRESTO, HCHS/SOL and Oregon SUDS maximizes the likelihood of achieving this objective.