Background Growing evidence suggests that compromised lung health may be linked to cardiovascular disease. However, little is known about its association with sudden cardiac death (SCD). Objectives We aimed to assess the link between impaired lung function, airflow obstruction and risk of SCD by race and gender in four US communities. Methods A total of 14 708 Atherosclerosis Risk in Communities (ARIC) study participants who underwent spirometry and were asked about lung health (1987–1989) were followed. The main outcome was physician-adjudicated SCD. Fine-Gray proportional subdistribution hazard models with Firth’s penalised partial likelihood correction were used to estimate the HRs. Results Over a median follow-up of 25.4 years, 706 (4.8%) subjects experienced SCD. The incidence of SCD was inversely associated with FEV1 in each of the four race and gender groups and across all smoking status categories. After adjusting for multiple measured confounders, HRs of SCD comparing the lowest with the highest quintile of FEV1 were 2.62 (95% CI 1.62 to 4.26) for white males, 1.80 (95% CI 1.03 to 3.15) for white females, 2.07 (95% CI 1.05 to 4.11) for black males and 2.62 (95% CI 1.21 to 5.65) for black females. The above associations were consistently observed among the never smokers. Moderate to very severe airflow obstruction was associated with increased risk of SCD. Addition of FEV1 significantly improved the predictive power for SCD. Conclusions Impaired lung function and airflow obstruction were associated with increased risk of SCD in general population. Additional research to elucidate the underlying mechanisms is warranted. All data relevant to the study are included in the article or uploaded as supplemental information. All data relevant to the study are included in the article or uploaded as supplementary information.

中文翻译：

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气流阻塞、肺功能受损和心源性猝死风险：一项前瞻性队列研究

背景 越来越多的证据表明，肺部健康受损可能与心血管疾病有关。然而，人们对其与心源性猝死（SCD）的关系知之甚少。目的 我们旨在评估美国四个社区中不同种族和性别的肺功能受损、气流阻塞和 SCD 风险之间的联系。方法 对 14708 名社区动脉粥样硬化风险 (ARIC) 研究参与者进行了随访，这些参与者接受了肺活量测定并被问及肺部健康（1987-1989 年）。主要结果是医生判定的 SCD。使用 Firth 惩罚部分似然校正的 Fine-Gray 比例子分布风险模型来估计 HR。结果 在 25.4 年的中位随访期间，706 名 (4.8%) 受试者经历了 SCD。在四个种族和性别组中的每一个以及所有吸烟状况类别中，SCD 的发生率都与 FEV1 呈负相关。在调整多个测量的混杂因素后，白人男性的 SCD 与 FEV1 的最低和最高五分之一的 HR 为 2.62（95% CI 1.62 至 4.26），白人女性为 1.80（95% CI 1.03 至 3.15），2.07（95%黑人男性的 CI 1.05 至 4.11）和黑人女性的 2.62（95% CI 1.21 至 5.65）。在从不吸烟者中始终观察到上述关联。中度至极重度气流阻塞与 SCD 风险增加有关。FEV1 的加入显着提高了 SCD 的预测能力。结论 肺功能受损和气流阻塞与一般人群 SCD 风险增加相关。需要进一步研究以阐明潜在机制。所有与研究相关的数据都包含在文章中或作为补充信息上传。所有与研究相关的数据都包含在文章中或作为补充信息上传。