Abstract 11553: Sudden Cardiac Death in Type 1 and Type 2 Diabetes

Abstract

Introduction: Diabetes is a known risk factor for sudden cardiac death (SCD). Whether type 1 diabetes mellitus (T1D) and type 2 diabetes mellitus (T2D) confer a similar risk of SCD remains unclear. Our aim was to determine and compare the association of T1D and T2D with SCD. Hypothesis: Given the differences in the pathophysiology, clinical presentation, and management, the likelihood of having SCD in T1D and T2D is different. Methods: Using data collected from 2002-19, we performed a case-control study of 2,771 cases of SCD (age ≥18 years) from the Oregon Sudden Unexpected Death Study and 8,313 control patients from Kaiser Permanente Northwest (matched for age, sex, and race/ethnicity) who did not have SCD or prior cardiac arrest. We used medical records to determine diabetes status and used logistic regression to evaluate the independent association between diabetes and SCD. Results: Our cases and matched controls had a mean age of 65 ± 16 years, were 33% female and 24% non-White race. In total, 37% (n=1,016) of cases and 24% (n=1,981) of controls had diabetes. In those with diabetes, the proportion of T1D was 6% (n=66) among cases and 2% among controls (n=40; P<0.001). The presence of diabetes was associated with a 1.5- times higher odds of SCD. Compared to those without diabetes, the odds ratio (OR) and 95% confidence interval (CI) for SCD was 4.36 (2.81–6.75; P<0.001) in T1D and 1.45 (95% CI, 1.30–1.63; P<0.001) in T2D after adjustment for age, sex, race/ethnicity, body mass index, and relevant comorbidities. Within the diabetic population (n=2,997), the odds of having SCD were 2.4 times higher in T1D than in T2D (adjusted OR: 2.41; 95% CI, 1.53–3.80; P<0.001). Conclusions: Individuals with T1D and T2D have a higher risk of SCD than those without diabetes. In the diabetic population, T1D is more strongly associated with SCD compared to T2D. These findings have implications for sudden death risk stratification in diabetics.