{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T05:20:23Z","timestamp":1787721623452,"version":"build-2784847793"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"13","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,7,7]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Although cardiovascular events increase sudden cardiac arrest (SCA) risk, the impact of recurrent events on subsequent SCA risk in a contemporary population is unknown. This study assessed whether patients with a first\u2010time acute coronary syndrome (ACS) or heart failure (HF) hospitalization who experience a recurrent cardiovascular event have increased SCA risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">The OSCAR (Observational Study of Cardiac Arrest Risk) is a prospective cohort with adjudicated SCA outcomes. The current study followed up patients who survived a first ACS or HF hospitalization (the index ACS or HF cohorts) for recurrent cardiovascular events and SCA. Recurrent event was a time\u2010dependent variable in Cox models predicting SCA. Findings were validated in the FHS (Framingham Heart Study).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Among 2946 patients in the index ACS cohort, incidence of SCA was higher following a recurrent ACS event than without (3.70 versus 1.28 per 100 patient\u2010years). A recurrent ACS event was associated with higher risk of SCA (adjusted hazard ratio [HR], 3.15 [95% CI, 2.06\u20134.83];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.0001). Among 6711 patients in the index HF cohort, incidence of SCA was higher following a recurrent HF event than without (1.35 versus 0.97 per 100 patient\u2010years), and SCA risk was higher with recurrent HF (HR, 1.79 [95% CI, 1.44\u20132.23];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.0001). In the FHS cohort, risk of SCA was higher with recurrent ACS (HR, 2.85 [95% CI, 1.66\u20134.90];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.0002); the association was not significant for recurrent HF (HR, 1.49 [95% CI, 0.73\u20133.03];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.27).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Recurrent events were associated with higher risk of SCA; dynamic clinical trajectories of recurrent cardiovascular events may inform prevention of SCA.<\/jats:p>\n                  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