Distinct Sex-Associated Phenotypes of Sudden Cardiac Arrest Across Clinical, ECG, and Echocardiographic Domains: Replication in Two Communities and Comparison with the Framingham Heart Study

In 5,130 out-of-hospital sudden cardiac arrest cases from ORSUDS, women showed higher odds of thyroid disease (2.56) and LVH (3.13) but lower odds of coronary artery disease (0.61) and reduced LVEF (0.40).

• Why it matters: Sex-specific risk stratification for sudden cardiac arrest underperforms in women, and it is unclear whether clinical, ECG, and echocardiographic patterns in cases replicate across communities.
• What they did: The study analyzed ORSUDS (Portland, 2002–2020) and externally replicated findings in PRESTO (Ventura County, 2015–2024) using multivariable-adjusted logistic regression across 38 comorbidities, 19 ECG, and 12 echocardiographic measures.
• The result: Most sex-associated differences in cases replicated in PRESTO (n=2,719), while comparisons to the community reference cohort FHS (n=3,539) showed several reversals, including QTc and LVH-related patterns.

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