Approved research

Understanding the Risk Factors Underlying Sudden Cardiac Death: An Investigation Utilising Bio, Genomic and Clinical Markers by the UK Biobank Cardio-Metabolic Consortium

Lay summary

This proposal will identify sudden deaths amongst the UK Biobank participants and then clarify the roles and importance of underlying causes such as coronary artery disease and high blood pressure. It will determine the clinical and genetic factors that may best identify those people who die suddenly due to heart disease, especially without any warning. The project will bring together a team of leading UK researchers from the Cardio-Metabolic Consortium in order to develop a risk score that will be unique in its scope. This research allows for follow-on work to understand the underlying mechanisms of sudden death. In the UK every year 100,000 people die suddenly due to heart disease. Half occur in individuals without any warning. Sudden death is poorly recorded in official statistics but is an important public health issue and sits well with the purpose of UK Biobank. Current methods for identification of those at greatest risk only addresses the minority of the population who have had prior life threatening events and/or have damaged hearts. This research aims to understand the risk factors for sudden death in order to deliver more effective prevention and treatments to more of the population. The research team is developing electronic methods for identification of UK Biobank participants who may have died suddenly. Their further evaluation will make use of information from GPs, hospitals, coroners and pathologists if and when available. The characteristics of the cases, including information from questionnaire, physical assessment, electrical heart tracings, blood samples and genetic background, will be compared to all other participants to find those factors associated with risk for sudden death over time. This will be undertaken between up to 2017 and then repeated at 5 year intervals as the group ages. We will develop a risk prediction test. The whole cohort will be utilised. By 2017 Biobank estimates that there will have been 17,000 cases of myocardial infarction amongst the cohort of which a proportion will have suffered coronary artery disease related deaths. Up to 25% may be sudden deaths. By 2022 this increases to 28,000. These cases will form the bulk of the sudden death group although confirmation and sub-classification of cases, especially non-coronary deaths, will increase numbers. Comparison will be made to the rest of the cohort including non-sudden deaths.