Risk Factors for Sudden Cardiac Death

SCD is a common cause of death, with around four to five million cases annually worldwide. Determining which persons are at high risk for SCD remains difficult, due to lack of knowledge on individual risk factors and because in the majority of cases, SCD is the first manifestation of cardiac disease. Therefore, this thesis had three aims: (i) to study the current and past incidence of SCD, (ii) to identify new risk factors for SCD in the general population, and (iii) to study characteristics of already known risk factors for SCD. We studied electrocardiographic (ECG) risk factors, clinical risk factors, pharmacological risk factors, and pharmacogenetic risk factors. Although the incidence of SCD declined in our population over the past two decades, awareness and prevention should remain an important issue in clinical care as well as at public health level. Additional preventive care, further improvement of cardiovascular disease management and better risk assessment will most likely lead to a further reduction in the health burden of SCD in the future. The studies described in this thesis have identified new risk factors for SCD and have described characteristics of already known risk factors. A next step towards a better risk stratification for SCD would be the development of a prediction model. The findings from this thesis can be used for the basis of such a prediction model.