CALIBER Sudden cardiac death phenotype

person Phenotype Sudden cardiac death
person Type Disease or syndrome
person Data sources Primary care (CPRD), hospital admission data (HES), mortality (ONS)
person Clinical Terminologies Read, ICD-10, ICD-9, OPCS-4
person Valid event date range 01/01/1999 - 01/07/2016
person Sex Female/Male
person Agreed 23.11.2012 (Revision 2)
person Authors Katherine I. Morley, Joshua Wallace , Spiros C. Denaxas, Ross J. Hunter, Riyaz S. Patel, Pablo Perel, Anoop D. Shah, Adam D. Timmis, Richard J. Schilling, Harry Hemingway

Primary Care (incident)

In the Clinical Practice Research Datalink (CPRD, primary care data) we ascertained sudden cardiac death (SCD) cases by searching for Read terms related to:

  • SCD diagnoses
  • ventricular arrhythmia
  • implantable cardioverter defibrillator
  • resuscitation


Read codeRead termCALIBER category
G575100 Sudden cardiac death, so described Sudden cardiac death

Read codeRead termCALIBER category
3282.00 ECG: ventricular tachycardia Ventricular tachycardia
G571.11 Ventricular tachycardia Ventricular tachycardia
3283.00 ECG: ventricular fibrillation Ventricular fibrillation
7L1H.13 Defibrillation Ventricular fibrillation
G574.00 Ventricular fibrillation and flutter Ventricular fibrillation
G574000 Ventricular fibrillation Ventricular fibrillation
G574011 Cardiac arrest-ventricular fibrillation Ventricular fibrillation
G574z00 Ventricular fibrillation and flutter NOS Ventricular fibrillation
7937500 Implantation of internal cardiac defibrillator Implanted cardiac defibrillation device
793F.00 Cardioverter defibrillator introduced through the vein Implanted cardiac defibrillation device
793F000 Implantat cardioverter defibrillator us one electrode lead Implanted cardiac defibrillation device
793F100 Implant cardioverter defibrillator using two electrode leads Implanted cardiac defibrillation device
793F500 Implantat cardiovert defibrillator us three electrode leads Implanted cardiac defibrillation device
793Fy00 Other specified cardioverter defibrillator intro thr vein Implanted cardiac defibrillation device
793Fz00 Cardioverter defibrillator introduced through the vein NOS Implanted cardiac defibrillation device
2241.00 O/E - collapse -cardiac arrest Asystole/EMD/cardiac arrest/resusc
7932111 Cardiac massage - open Asystole/EMD/cardiac arrest/resusc
7L1H600 Advanced cardiopulmonary resuscitation Asystole/EMD/cardiac arrest/resusc
853..00 Cardiac massage - external Asystole/EMD/cardiac arrest/resusc
8531.00 Closed cardiac massage alone Asystole/EMD/cardiac arrest/resusc
8532.00 Closed cardiac massage+ventil. Asystole/EMD/cardiac arrest/resusc
8532.11 Cardiopulmonary resuscitation Asystole/EMD/cardiac arrest/resusc
853Z.00 External cardiac massage NOS Asystole/EMD/cardiac arrest/resusc
G575.00 Cardiac arrest Asystole/EMD/cardiac arrest/resusc
G575.11 Cardio-respiratory arrest Asystole/EMD/cardiac arrest/resusc
G575.12 Asystole Asystole/EMD/cardiac arrest/resusc
G575000 Cardiac arrest with successful resuscitation Asystole/EMD/cardiac arrest/resusc
G575200 Electromechanical dissociation with successful resuscitation Asystole/EMD/cardiac arrest/resusc
G575300 Electromechanical dissociation Asystole/EMD/cardiac arrest/resusc
G575z00 Cardiac arrest, unspecified Asystole/EMD/cardiac arrest/resusc
SP11000 Cardiac arrest as a complication of care Asystole/EMD/cardiac arrest/resusc

Read terms are hierarhically organized in top-level chapters i.e. chapter G....00 is related to Circulatory System Diseases and sub-headings i.e. heading G2...00 is related to Hypertensive Heart Disease while G3...00 is related to Ischaemic Heart Disease.

Secondary Care (incident and prevalent)

In Hospital Episode Statistics (HES, secondary care data) we used primary diagnosis of ICD-10 codes related to:

  • SCD diagnoses
  • ventricular arrhythmia
  • implantable cardioverter defibrillator
  • resuscitation

ICD-10 codeICD-10 termCALIBER category
I472 Ventricular tachycardia Ventricular tachycardia
I490 Ventricular fibrillation and flutter Ventricular fibrillation
I460 Cardiac arrest with successful resuscitation Asystole/EMD/cardiac arrest/resusc
I469 Cardiac arrest, unspecified Asystole/EMD/cardiac arrest/resusc
I470 Re-entry ventricular arrhythmia Re-entry ventricular arrhythmia

ICD-10 codeICD-10 termCALIBER category
I461 Sudden cardiac death, so described Sudden cardiac death

We additionally searched for OPCS-4 terms related to:

  • implantable cardioverter defibrillator
  • resuscitation

OPCS-4 codeOPCS-4 termCALIBER category
K59 Cardioverter defibrillator introduced through the vein Implanted cardiac defibrillation device
K59.1 Implantation of cardioverter defibrillator using one electrode lead Implanted cardiac defibrillation device
K59.2 Implantation of cardioverter defibrillator using two electrode leads Implanted cardiac defibrillation device
K59.3 Resiting of lead of cardioverter defibrillator Implanted cardiac defibrillation device
K59.4 Renewal of cardioverter defibrillator Implanted cardiac defibrillation device
K59.5 Removal of cardioverter defibrillator Implanted cardiac defibrillation device
K59.6 Implantation of cardioverter defibrillator using three electrode leads Implanted cardiac defibrillation device
K59.8 Other specified cardioverter defibrillator introduced through the vein Implanted cardiac defibrillation device
K59.9 Unspecified cardioverter defibrillator introduced through the vein Implanted cardiac defibrillation device
X50 External resuscitation Asystole/EMD/cardiac arrest/resusc
X50.1 Direct current cardioversion Asystole/EMD/cardiac arrest/resusc
X50.2 External cardioversion NEC Asystole/EMD/cardiac arrest/resusc
X50.3 Advanced cardiac pulmonary resuscitation Asystole/EMD/cardiac arrest/resusc
X50.4 External ventricular defibrillation Asystole/EMD/cardiac arrest/resusc
X50.8 Other specified external resuscitation Asystole/EMD/cardiac arrest/resusc
X50.9 Unspecified external resuscitation Asystole/EMD/cardiac arrest/resusc

In the Office for National Statistics (ONS) mortality register, we used ICD-10 and ICD-9 terms to identify cases based on the underlying cause of death:

  • SCD diagnoses
  • ventricular arrhythmia
  • implantable cardioverter defibrillator
  • resuscitation

ICD-10 codeICD-10 termCALIBER category
I461 Sudden cardiac death, so described Sudden cardiac death

ICD-9 codeICD-9 termCALIBER category

ICD-10 codeICD-10 termCALIBER category
I472 Ventricular tachycardia Ventricular tachycardia
I490 Ventricular fibrillation and flutter Ventricular fibrillation
I460 Cardiac arrest with successful resuscitation Asystole/EMD/cardiac arrest/resusc
I469 Cardiac arrest, unspecified Asystole/EMD/cardiac arrest/resusc
I470 Re-entry ventricular arrhythmia Re-entry ventricular arrhythmia

ICD-9 codeICD-9 termCALIBER category
4271 Cardiac dysrhythmias ; Paroxysmal ventricular tachycardia cardiac_arrest
4275 Cardiac dysrhythmias ; Cardiac arrest cardiac_arrest

Combining evidence across sources to define and date phenotypes

Primary care diagnosis of sudden cardiac death:
Secondary care diagnosis of sudden cardiac death
Sudden cardiac death as the cause of death
Sudden cardiac death prior to 2001

Ventricular arrhythmia / cardiac arrest:
Includes ventricular tachycardia, ventricular fibrillation, re-entry ventricular arrhythmia, implantable cardioverter defibrillator, asystole, pulseless electrical activity, cardiac arrest or resuscitation

Primary care diagnosis of ventricular arrhythmia, cardiac arrest, implantable cardioverter defibrillator or resuscitation
Secondary care diagnosis of ventricular arrhythmia, cardiac arrest or resuscitation
Secondary care procedure code for implantable cardioverter defibrillator or resuscitation
Ventricular arrhythmia, cardiac arrest or resuscitation as the cause of death
Ventricular arrhythmia, cardiac arrest or resuscitation as the cause of death prior to 2001

Version 1 of this phenotype had an identical algorithm but included two additional OPCS codes: X501 (Direct current cardioversion) and X502 (External cardioversion NEC). These codes tended to be used to record cardioversion in patients with atrial fibrillation rather than ventricular arrhythmia.
Risk factor Publication
Sex How Does Cardiovascular Disease First Present in Women and Men? Incidence of 12 Cardiovascular Diseases in a Contemporary Cohort of 1,937,360 People. Circulation. 2015 Oct 6;132(14):1320-8. doi: 10.1161/CIRCULATIONAHA.114.013797. Epub 2015 Sep 1.
Type 2 diabetes Type 2 diabetes and incidence of a wide range of cardiovascular diseases: a cohort study in 1.9 million people. Lancet. 2015 Feb 26;385 Suppl 1:S86. doi: 10.1016/S0140-6736(15)60401-9.
Smoking Heterogeneous associations between smoking and a wide range of initial presentations of cardiovascular disease in 1937360 people in England: lifetime risks and implications for risk prediction. Int J Epidemiol. 2015 Feb;44(1):129-41. doi: 10.1093/ije/dyu218. Epub 2014 Nov 20.
Socioeconomic status Socioeconomic deprivation and the incidence of 12 cardiovascular diseases in 1.9 million women and men: implications for risk prediction and prevention. PLoS One. 2014 Aug 21;9(8):e104671. doi: 10.1371/journal.pone.0104671. eCollection 2014.
Blood pressure Blood pressure and incidence of twelve cardiovascular diseases: lifetime risks, healthy life-years lost, and age-specific associations in 1.25 million people. Lancet. 2014 May 31;383(9932):1899-911. doi: 10.1016/S0140-6736(14)60685-1.
Heart rate Archangelidi O et al. Clinically recorded heart rate and incidence of 12 coronary, cardiac, cerebrovascular and peripheral arterial diseases in 233,970 men and women: A linked electronic health record study. Eur J Prev Cardiol. 2018 Sep;25(14):1485-1495. doi: 10.1177/2047487318785228. Epub 2018 Jul 2.
Ethnicity George J et al. Ethnicity and the first diagnosis of a wide range of cardiovascular diseases: Associations in a linked electronic health record cohort of 1 million patients. PLoS One. 2017 Jun 9;12(6):e0178945. doi: 10.1371/journal.pone.0178945. eCollection 2017.
Alcohol Association between clinically recorded alcohol consumption and initial presentation of 12 cardiovascular diseases: population based cohort study using linked health records. BMJ. 2017 Mar 22;356:j909. doi: 10.1136/bmj.j909.
Giant cell arteritis Associations between polymyalgia rheumatica and giant cell arteritis and 12 cardiovascular diseases. Heart. 2016 Mar;102(5):383-9. doi: 10.1136/heartjnl-2015-308514. Epub 2016 Jan 19
Giant cell arteritis Associations between polymyalgia rheumatica and giant cell arteritis and 12 cardiovascular diseases. Heart. 2016 Mar;102(5):383-9. doi: 10.1136/heartjnl-2015-308514. Epub 2016 Jan 19
Neutrophils Neutrophil Counts and Initial Presentation of 12 Cardiovascular Diseases: A CALIBER Cohort Study. J Am Coll Cardiol. 2017 Mar 7;69(9):1160-1169. doi: 10.1016/j.jacc.2016.12.022.
Eosinophils Low eosinophil and low lymphocyte counts and the incidence of 12 cardiovascular diseases: a CALIBER cohort study. Open Heart. 2016 Sep 5;3(2):e000477. doi: 10.1136/openhrt-2016-000477. eCollection 2016.
Depression Depression as a Risk Factor for the Initial Presentation of Twelve Cardiac, Cerebrovascular, and Peripheral Arterial Diseases: Data Linkage Study of 1.9 Million Women and Men. PLoS One. 2016 Apr 22;11(4):e0153838. doi: 10.1371/journal.pone.0153838. eCollection 2016.
Polymyalgia rheumatica Associations between polymyalgia rheumatica and giant cell arteritis and 12 cardiovascular diseases. Heart. 2016 Mar;102(5):383-9. doi: 10.1136/heartjnl-2015-308514. Epub 2016 Jan 19
Lymphocytes Low eosinophil and low lymphocyte counts and the incidence of 12 cardiovascular diseases: a CALIBER cohort study. Open Heart. 2016 Sep 5;3(2):e000477. doi: 10.1136/openhrt-2016-000477. eCollection 2016.
Rheumatoid arthritis Rheumatoid Arthritis and Incidence of Twelve Initial Presentations of Cardiovascular Disease: A Population Record-Linkage Cohort Study in England. PLoS One. 2016 Mar 15;11(3):e0151245. doi: 10.1371/journal.pone.0151245.
Risk factor Publication
Sex How Does Cardiovascular Disease First Present in Women and Men? Incidence of 12 Cardiovascular Diseases in a Contemporary Cohort of 1,937,360 People. Circulation. 2015 Oct 6;132(14):1320-8. doi: 10.1161/CIRCULATIONAHA.114.013797. Epub 2015 Sep 1.
Type 2 diabetes Type 2 diabetes and incidence of a wide range of cardiovascular diseases: a cohort study in 1.9 million people. Lancet. 2015 Feb 26;385 Suppl 1:S86. doi: 10.1016/S0140-6736(15)60401-9.
Smoking Heterogeneous associations between smoking and a wide range of initial presentations of cardiovascular disease in 1937360 people in England: lifetime risks and implications for risk prediction. Int J Epidemiol. 2015 Feb;44(1):129-41. doi: 10.1093/ije/dyu218. Epub 2014 Nov 20.
Socioeconomic status Socioeconomic deprivation and the incidence of 12 cardiovascular diseases in 1.9 million women and men: implications for risk prediction and prevention. PLoS One. 2014 Aug 21;9(8):e104671. doi: 10.1371/journal.pone.0104671. eCollection 2014.
Blood pressure Blood pressure and incidence of twelve cardiovascular diseases: lifetime risks, healthy life-years lost, and age-specific associations in 1.25 million people. Lancet. 2014 May 31;383(9932):1899-911. doi: 10.1016/S0140-6736(14)60685-1.
Heart rate Archangelidi O et al. Clinically recorded heart rate and incidence of 12 coronary, cardiac, cerebrovascular and peripheral arterial diseases in 233,970 men and women: A linked electronic health record study. Eur J Prev Cardiol. 2018 Sep;25(14):1485-1495. doi: 10.1177/2047487318785228. Epub 2018 Jul 2.
Ethnicity George J et al. Ethnicity and the first diagnosis of a wide range of cardiovascular diseases: Associations in a linked electronic health record cohort of 1 million patients. PLoS One. 2017 Jun 9;12(6):e0178945. doi: 10.1371/journal.pone.0178945. eCollection 2017.
Alcohol Association between clinically recorded alcohol consumption and initial presentation of 12 cardiovascular diseases: population based cohort study using linked health records. BMJ. 2017 Mar 22;356:j909. doi: 10.1136/bmj.j909.
Giant cell arteritis Associations between polymyalgia rheumatica and giant cell arteritis and 12 cardiovascular diseases. Heart. 2016 Mar;102(5):383-9. doi: 10.1136/heartjnl-2015-308514. Epub 2016 Jan 19
Giant cell arteritis Associations between polymyalgia rheumatica and giant cell arteritis and 12 cardiovascular diseases. Heart. 2016 Mar;102(5):383-9. doi: 10.1136/heartjnl-2015-308514. Epub 2016 Jan 19
Neutrophils Neutrophil Counts and Initial Presentation of 12 Cardiovascular Diseases: A CALIBER Cohort Study. J Am Coll Cardiol. 2017 Mar 7;69(9):1160-1169. doi: 10.1016/j.jacc.2016.12.022.
Eosinophils Low eosinophil and low lymphocyte counts and the incidence of 12 cardiovascular diseases: a CALIBER cohort study. Open Heart. 2016 Sep 5;3(2):e000477. doi: 10.1136/openhrt-2016-000477. eCollection 2016.
Depression Depression as a Risk Factor for the Initial Presentation of Twelve Cardiac, Cerebrovascular, and Peripheral Arterial Diseases: Data Linkage Study of 1.9 Million Women and Men. PLoS One. 2016 Apr 22;11(4):e0153838. doi: 10.1371/journal.pone.0153838. eCollection 2016.
Polymyalgia rheumatica Associations between polymyalgia rheumatica and giant cell arteritis and 12 cardiovascular diseases. Heart. 2016 Mar;102(5):383-9. doi: 10.1136/heartjnl-2015-308514. Epub 2016 Jan 19
Lymphocytes Low eosinophil and low lymphocyte counts and the incidence of 12 cardiovascular diseases: a CALIBER cohort study. Open Heart. 2016 Sep 5;3(2):e000477. doi: 10.1136/openhrt-2016-000477. eCollection 2016.
Rheumatoid arthritis Rheumatoid Arthritis and Incidence of Twelve Initial Presentations of Cardiovascular Disease: A Population Record-Linkage Cohort Study in England. PLoS One. 2016 Mar 15;11(3):e0151245. doi: 10.1371/journal.pone.0151245.
Gho JMIH et al. An electronic health records cohort study on heart failure following myocardial infarction in England: incidence and predictors. BMJ Open. 2018 Mar 3;8(3):e018331. doi: 10.1136/bmjopen-2017-018331. PMID: 29502083


Steele AJ et al. Machine learning models in electronic health records can outperform conventional survival models for predicting patient mortality in coronary artery disease. PLoS One. 2018 Aug 31;13(8):e0202344. doi: 10.1371/journal.pone.0202344. eCollection 2018. PMID: 30169498


Archangelidi O et al. Clinically recorded heart rate and incidence of 12 coronary, cardiac, cerebrovascular and peripheral arterial diseases in 233,970 men and women: A linked electronic health record study. Eur J Prev Cardiol. 2018 Sep;25(14):1485-1495. doi: 10.1177/2047487318785228. Epub 2018 Jul 2. PMID: 29966429


Koudstaal S et al. Prognostic burden of heart failure recorded in primary care, acute hospital admissions, or both: a population-based linked electronic health record cohort study in 2.1 million people. Eur J Heart Fail. 2017 Sep;19(9):1119-1127. doi: 10.1002/ejhf.709. Epub 2016 Dec 23. PMID: 28008698


Chung SC et al. Time spent at blood pressure target and the risk of death and cardiovascular diseases. PLoS One. 2018 Sep 5;13(9):e0202359. doi: 10.1371/journal.pone.0202359. eCollection 2018. PMID: 30183734


Bell S et al. Association between clinically recorded alcohol consumption and initial presentation of 12 cardiovascular diseases: population based cohort study using linked health records. BMJ. 2017 Mar 22;356:j909. PMID: 28331015


Pasea L et al. Personalising the decision for prolonged dual antiplatelet therapy: development, validation and potential impact of prognostic models for cardiovascular events and bleeding in myocardial infarction survivors. Eur Heart J. 2017 Apr 7;38(14):1048-1055. doi: 10.1093/eurheartj/ehw683. PMID: 28329300


Shah AD et al. Neutrophil Counts and Initial Presentation of 12 Cardiovascular Diseases: A CALIBER Cohort Study. J Am Coll Cardiol. 2017 Mar 7;69(9):1160-1169. doi: 10.1016/j.jacc.2016.12.022. PMID: 28254179


Asaria M et al. Using electronic health records to predict costs and outcomes in stable coronary artery disease. Heart. 2016 May 15;102(10):755-62. doi: 10.1136/heartjnl-2015-308850. Epub 2016 Feb 10. PMID: 26864674


Daskalopoulou M et al. Depression as a Risk Factor for the Initial Presentation of Twelve Cardiac, Cerebrovascular, and Peripheral Arterial Diseases: Data Linkage Study of 1.9 Million Women and Men. PLoS One. 2016 Apr 22;11(4):e0153838. doi: 10.1371/journal.pone.0153838. eCollection 2016. PMID: 27105076


Pujades-Rodriguez M et al. Associations between polymyalgia rheumatica and giant cell arteritis and 12 cardiovascular diseases. Heart. 2016 Mar;102(5):383-9. doi: 10.1136/heartjnl-2015-308514. Epub 2016 Jan 19. PMID: 26786818


Pujades-Rodriguez M et al. Rheumatoid Arthritis and Incidence of Twelve Initial Presentations of Cardiovascular Disease: A Population Record-Linkage Cohort Study in England. PLoS One. 2016 Mar 15;11(3):e0151245. doi: 10.1371/journal.pone.0151245. eCollection 2016. PMID: 26978266


Shah AD et al. Low eosinophil and low lymphocyte counts and the incidence of 12 cardiovascular diseases: a CALIBER cohort study. Open Heart. 2016 Sep 5;3(2):e000477. doi: 10.1136/openhrt-2016-000477. eCollection 2016. PMID: 27621833


Timmis A et al. Prolonged dual antiplatelet therapy in stable coronary disease: comparative observational study of benefits and harms in unselected versus trial populations. BMJ. 2016 Jun 22;353:i3163. PMID: 27334486


Walker S et al. Long-term healthcare use and costs in patients with stable coronary artery disease: a population-based cohort using linked health records (CALIBER). Eur Heart J Qual Care Clin Outcomes. 2016 Jan 20;2(2):125-140. doi: 10.1093/ehjqcco/qcw003. PMID: 27042338


George J et al. How Does Cardiovascular Disease First Present in Women and Men? Incidence of 12 Cardiovascular Diseases in a Contemporary Cohort of 1,937,360 People. Circulation. 2015 Oct 6;132(14):1320-8. doi: 10.1161/CIRCULATIONAHA.114.013797. Epub 2015 Sep 1. PMID: 26330414


Morley KI et al. Defining disease phenotypes using national linked electronic health records: a case study of atrial fibrillation. PLoS One. 2014 Nov 4;9(11):e110900. doi: 10.1371/journal.pone.0110900. eCollection 2014. PMID: 25369203


Pujades-Rodriguez M et al. Heterogeneous associations between smoking and a wide range of initial presentations of cardiovascular disease in 1937360 people in England: lifetime risks and implications for risk prediction. Int J Epidemiol. 2015 Feb;44(1):129-41. doi: 10.1093/ije/dyu218. Epub 2014 Nov 20. PMID: 25416721


Pujades-Rodriguez M et al. Socioeconomic deprivation and the incidence of 12 cardiovascular diseases in 1.9 million women and men: implications for risk prediction and prevention. PLoS One. 2014 Aug 21;9(8):e104671. doi: 10.1371/journal.pone.0104671. eCollection 2014. PMID: 25144739


Rapsomaniki E et al. Blood pressure and incidence of twelve cardiovascular diseases: lifetime risks, healthy life-years lost, and age-specific associations in 1.25 million people. Lancet. 2014 May 31;383(9932):1899-911. doi: 10.1016/S0140-6736(14)60685-1. PMID: 24881994


Shah AD et al. Type 2 diabetes and incidence of cardiovascular diseases: a cohort study in 1.9 million people. Lancet Diabetes Endocrinol. 2015 Feb;3(2):105-13. doi: 10.1016/S2213-8587(14)70219-0. Epub 2014 Nov 11. PMID: 25466521


Rapsomaniki E et al. Prognostic models for stable coronary artery disease based on electronic health record cohort of 102 023 patients. Eur Heart J. 2014 Apr;35(13):844-52. doi: 10.1093/eurheartj/eht533. Epub 2013 Dec 17. PMID: 24353280