Background: The relationship between anemia and sudden cardiac arrest (SCA) is unclear in the general population, so we assessed it in a nationwide cohort. Methods and Results: We studied 494,948 subjects (mean age, 47.8 years; 245,333 men [49.6%]) with national health check-up data from the Korean National Health Insurance Database Cohort. During a mean follow-up period of 5.4 years, SCA occurred in 616 participants (396 men, 220 women). The incidence rates of SCA increased across the 4 anemia groups in both men (0.3, 1.5, 5.3, and 4.5 per 1,000 person-years) and women (0.2, 0.5, 0.5, and 1.2 per 1,000 person-years). The SCA risk per 1-unit decrease in hemoglobin (Hb) increased by 21% and 24%, respectively, in multivariable models adjusted for cardiovascular factors, in men (95% confidence interval [CI], 13–29%; P<0.001) and women (95% CI, 13–37%; P<0.001). A negative correlation between QTc interval and Hb level was observed in men, and a trend was observed in women. Conclusions: Anemia was associated with an increased risk of SCA even after accounting for concomitant conditions in a South Korean nationwide cohort. The correlation between anemia and SCA might be explained by an increase in arrhythmic risks, such as QTc prolongation.
Bibliographical noteFunding Information:
This study was supported in part by research grants from the Basic Science Research Program through the National Research Foundation of Korea, Seoul, funded by the Ministry of Education, Science, and Technology (NRF-2012R1A2A2A02045367, 2010-0021993), as well as grants from the Korean Healthcare Technology R&D project funded by the Ministry of Health & Welfare (HI12C1552, HI16C0058, HI15C1200).
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All Science Journal Classification (ASJC) codes
- Cardiology and Cardiovascular Medicine