In Spain, 17,241 sudden cardiac deaths are recorded every year
The incidence of sudden cardiac death (SCD) in the Mediterranean area is one third lower than in countries in northern Europe and America. This is the conclusion of a study co‑led by the Pere Virgili Health Research Institute (IISPV) and the Catalan Medical Emergency System (SEM), with the participation of the Institute of Legal Medicine and Forensic Sciences of Catalonia (IMLCFC), Joan XXIII University Hospital of Tarragona, Sant Joan University Hospital of Reus, Xarxa Santa Tecla, IDIAP Jordi Gol, Rovira i Virgili University, and the Catalan Health Institute. The study, recently published in the international journal BMJ Global Health, analyses the factors that explain the lower impact of sudden cardiac death in the Mediterranean region.
According to the study (Epidemiology of sudden cardiac arrest in the western Mediterranean area based on a prospective registry), 70% of sudden deaths are caused by cardiac conditions. Chronic coronary disease is identified as the main cause of sudden death, followed by acute coronary disease and cardiomyopathies. In addition, 15% of sudden deaths are due to non‑cardiac cardiovascular causes, such as pulmonary thromboembolism or intracranial haemorrhage. The remaining 15% are related to non‑cardiovascular causes, such as digestive bleeding or infections. Alfredo Bardají, cardiologist at Joan XXIII University Hospital, highlights that “this study found that acute myocardial infarction as a cause of sudden cardiac death is decreasing, thanks to improvements in early treatment”.
Regarding the possible prevention of sudden death, Youcef Azeli, principal investigator of the study, SEM doctor, physician at Sant Joan University Hospital of Reus and head of the IISPV research group in emergencies, explains that “only one third of patients have a previous history of heart disease, which makes prediction difficult. Also, in 50% of cases, cardiac arrest occurs without previous symptoms, which makes treatment harder”. Even so, the study shows that one in five patients had a medical consultation in the four weeks before the event, which highlights the need to work on medium‑term prevention strategies to improve the detection of patients at risk.
This research is also relevant for two additional reasons. First, it involved up to six institutions, which made it possible to gather information from many different sources. In this regard, the participation of the Institute of Legal Medicine and Forensic Sciences of Catalonia (IMLCFC), part of the Department of Justice and Democratic Quality, is especially important. Its director, Eneko Barbería, points out that “including forensic analyses and data allows us to obtain a complete picture of sudden cardiac death and makes this study unique in the Mediterranean area and in Europe”.
Second, this is the first study that provides real data on the incidence of sudden death in Catalonia and Spain, thanks to the wide participation of institutions that contributed information. According to the Catalonia Cardiac Arrest and Sudden Death Registry (RAIMCAT), 2,700 cases are recorded every year in Catalonia and initially attended by SEM, which means 7 cases per day. In Spain as a whole, the annual number is 17,241 cases, or 47 cases per day. This study, unique in Europe, shows that sudden cardiac death is one of the most important causes of death in Spain, just after lung cancer.
The survival rate after sudden cardiac arrest is only 10%. Cases with previous chest pain or where an automated external defibrillator (AED) is used before SEM arrives have a better chance of survival. For this reason, in the presence of warning signs such as chest pain, or when witnessing a sudden loss of consciousness, it is essential to recognise the situation quickly, start high‑quality chest compressions, and use an AED as soon as possible.
This study, funded by the Catalan Resuscitation Council (CCR), has made it possible to identify the cause of death in a higher percentage of cases than other published studies. Research like this, with high‑quality registries on sudden cardiac death, helps advance precision medicine, prevention, and treatments that improve patient care.
Reference: Azeli, Y., Barbería, E., Solà-Muñoz, S., Landín, I., Fernández, A., Rey-Reñones, C., García-Gual, C., Gomez-Tortosa, A., Granado-Font, E., Fernandez-Sender, L., García-Vilana, S., Bonet, G., Jimènez-Fàbrega, X., & Bardaji, A. (2025). Epidemiology of sudden cardiac arrest in the western Mediterranean area based on a prospective registry. BMJ global health, 10(11), e020462. https://doi.org/10.1136/bmjgh-2025-020462
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