New NHLBI grant to support development of prevention strategies for deadly heart condition

One of medicine's most prominent experts in sudden cardiac arrest has received a new $2.36 million grant to study how to better predict the deadly heart condition that kills an estimated 300,000 Americans each year.

Over recent years, Sumeet S. Chugh, MD, and his team of researchers in the Cedars-Sinai Heart Institute have identified several risk factors for sudden cardiac arrest, including levels of sex hormones in the blood, genetics and electrical and structural abnormalities of the heart.

The new grant from the National Heart, Lung, and Blood Institute will support research with patients 35-59 years old. To date, most published studies have focused almost exclusively on patients 60 and older.

"The societal burden is greater when someone in their middle years is stricken with sudden cardiac arrest because if they die, they are more likely to leave behind dependents and if, by some miracle, they survive, they are less likely to be self-supporting," said Chugh, associate director of the Cedars-Sinai Heart Institute and the Pauline and Harold Price Chair in Cardiac Electrophysiology Research. "Because fewer than 5 percent of sudden cardiac arrest patients survive, the only way we can protect patients is to be able to predict who is more likely to experience the condition."

Although "sudden cardiac arrest" and "heart attack" are often used interchangeably, the terms are not synonymous. Unlike heart attacks - myocardial infarction - which are typically caused by clogged coronary arteries reducing blood flow to the heart muscle, sudden cardiac arrest is the result of defective electrical activity of the heart. Patients may have little or no warning, and the disorder usually causes instantaneous death. Sudden cardiac arrest has been blamed for the deaths of journalist Tim Russert and filmmaker John Hughes.

"Preliminary research shows that middle-aged people who have a sudden cardiac arrest are more likely to present without prior warning," Chugh said, "and they are more likely to be obese and nonwhite."

In addition to his leadership role at the Cedars-Sinai Heart Institute, Chugh heads the Oregon Sudden Unexpected Death Study, a comprehensive, 16-hospital, multiyear assessment of cardiac deaths in the 1 million population Portland, Oregon metropolitan area now ongoing for more than a decade. The data collected in that study provides Chugh and his team with unique, community-based information to mine for answers to what causes sudden cardiac arrest.

"Sudden cardiac arrest is one of the great mysteries in cardiology," said Eduardo Marbán, MD, PhD, director of the Cedars-Sinai Heart Institute. "Despite the public's increased awareness of the importance of CPR, we might achieve better survival rates only if we can predict who is at greatest risk. That is why this work is so important."