{
  "abstract": "Background: Sex differences in sudden cardiac arrest (SCA) incidence and outcomes are well established, but risk stratification underperforms in women. It is important to delineate sex-specific patterns in SCA across clinical, electrocardiographic, and echocardiographic domains. Methods: We studied out-of-hospital SCA cases from the Oregon Sudden Unexpected Death Study (ORSUDS; Portland, 2002-2020; discovery) and Prediction of Sudden Death in Multi-Ethnic Communities (PRESTO; Ventura County, 2015-2024; external replication). Sex differences in 38 comorbidities, 19 ECG and 12 echocardiographic measures were estimated using multivariable-adjusted logistic regression. Female sex was the modeled dependent measure (male as reference). ORSUDS estimates were compared with those in the Framingham Heart Study (FHS), a community-based reference cohort, using FDR-adjusted Cochran Q tests. Results: Among 5130 ORSUDS cases, 1715 (33.4%) were women (median age, 70.4 years [IQR, 58.7-81.8]) and 3415 (66.6%) were men (65.6 [55.0-76.8]). Compared with men, women had higher BMI (per 5 kg/m2, 1.11 [1.08-1.15]) and higher odds of thyroid disease (2.56 [2.17-3.13]), asthma (2.33 [1.92-2.86]), mood disorder (2.17 [1.85-2.50]), dementia (1.27 [1.02-1.56]), and left ventricular hypertrophy (LVH, 3.13 [2.44-4.00]). Women also had lower odds of coronary artery disease (0.61 [0.52-0.71]), atrial fibrillation (0.67 [0.56-0.79]), prolonged QTc (0.45 [0.35-0.57]), prolonged PR (0.53 [0.41-0.68]), premature contractions (0.77 [0.60-0.98]), sleep apnea (0.53 [0.43-0.65]), and reduced LVEF (0.40 [0.29-0.54]). Most findings were replicated in PRESTO (n=2719). In contrast, several of these differences were reversed in the community (FHS, n=3539;FDR-significant): prolonged QTc was more common in women, whereas LVH, dementia, heart failure, and higher BMI were more common in men. Conclusions: Sex differences among SCA cases were mostly reproducible in SCA cohorts, and distinct from sex-related patterns in the community. These results have implications for development of sex-specific SCA risk assessment and prevention strategies.",
  "abstract_shown": true,
  "affiliations": [
    "Cedars-Sinai Health System"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "name": "T. T. T. T. Truyen"
    },
    {
      "affs": [
        0
      ],
      "name": "H. Chugh"
    },
    {
      "name": "D. Nguyen"
    },
    {
      "name": "K. Nakamura"
    },
    {
      "name": "A. Uy-Evanado"
    },
    {
      "name": "E. J. Benjamin"
    },
    {
      "name": "K. Reinier"
    },
    {
      "affs": [
        0
      ],
      "name": "S. S. Chugh"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/07yxvc4ghp2h2.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.10.30.26366963",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.10.30.26366963v1.full",
  "id": "07yxvc4ghp2h2",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.10.30.26366963v1",
  "language": null,
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "cardiovascular medicine"
    ]
  ],
  "openalex": null,
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.10.30.26366963v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-30",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/07yxvc4ghp2h2.ris",
  "sources": [
    {
      "first_seen": "2026-11-04T00:21:04Z",
      "native_id": "10.64898/2026.10.30.26366963",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.10.30.26366963v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:cardiovascular medicine",
      "subfield": "cardiovascular"
    }
  ],
  "title": "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",
  "title_text": "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",
  "type": "preprint",
  "updated_at": "2026-11-05T00:20:36Z",
  "url": "https://research.draconitic.com/paper/07yxvc4ghp2h2",
  "venue": "medRxiv",
  "versions": []
}