How data demystifies sudden cardiac arrest
Researchers have long struggled to study sudden cardiac arrests that take place outside of hospitals. An ongoing EU-funded project is harmonising research from across Europe to bring clarity to this complex disease.
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A sudden cardiac arrest can occur without warning, with victims often unaware they had even been at risk. The condition strikes when the electrical signals that control a hearts rhythm malfunction, preventing blood from reaching major organs. Since it takes just seconds for a person to lose consciousness, the window of opportunity to save them is small.
Life-saving treatment usually shocking the heart back to its normal rhythm using a defibrillator machine must be administered within the first few minutes, which is why survival rates after sudden cardiac arrests are so low. Out-of-hospital arrests account for approximately half of all cardiac-related deaths and up to 20 % of all natural deaths in industrialised countries.
To try to prevent sudden cardiac arrest from occurring, and to help more people survive the condition, the researchers behind the EU-funded ESCAPE-NET project have created Europes largest database which will help them to decipher what factors cause sudden cardiac arrests that take place outside of hospitals and what first-response treatment works best.
For years, European research institutions have collected data about sudden cardiac arrest victims in their area. However, ESCAPE-NET is the first project to successfully merge that information into one huge, cross-border database.
One of our main achievements so far is how we have combined the efforts of investigators who have spent their entire career investigating this issue, says Hanno Tan, project coordinator and a cardiologist at the University of Amsterdam in the Netherlands. By combining data from across Europe, we get numbers of a sufficient magnitude to carry out a thorough study of sudden cardiac arrest, while also taking into account the complexities of the disease.
The database is still growing: today it contains 10 000 DNA samples and 80 000 patient samples, detailing information such as where a persons sudden cardiac arrest took place, how they were resuscitated, what medication that person was taking and what medical conditions they suffered from previously.
Within this data, researchers have already unearthed ground-breaking findings such as the fact that women suffering from sudden cardiac arrest are less likely to be resuscitated, and that certain medications put people at greater risk. The ESCAPE-NET team are still investigating why these discrepancies exist but their conclusions are expected to help European countries create systems whereby everyone can receive more personalised treatment and faster resuscitation, leveraging new technology where necessary.
According to Tan, this data will help researchers answer crucial questions, such as: How many life-saving defibrillator machines does a city need? Where do you place them? How do you alert people who can use these machines that a cardiac arrest is taking place? Amalgamating data collected across Europe has also helped researchers compare different countries strategies, identifying which works best.
Foundation for future research
The projects database has already enabled researchers to make novel findings that could ultimately save lives. However, the project team believes there is more crucial information buried within the data. While ESCAPE-NET researchers are currently focused on designing a personalised risk score that will help people to seek treatment before they suffer a sudden cardiac arrest, they also want to enable other researchers to use the database as a foundation for their own work. That is why on 1 January 2020 the data will be made available to other investigators.
Making this dataset freely available will be revolutionary for researchers working in this sector. Until now, sudden cardiac arrest has been difficult for researchers to study, says Tan. This is because the disease often occurs outside of hospitals and also the time frame to collect all the data is very limited after the first 10 minutes you are too late, the person is deceased and you dont know what happened.
Tan is hoping the database will help researchers and cardiologists achieve more clarity when working on this mysterious condition. I hope the project means we will be better able to understand the causes of sudden cardiac arrest as well as the best ways to treat it once it has happened, he says. I believe our insights will lead to better prevention and treatment.