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Comment & Response
June 21, 2021

Fishing for an Association With Sudden Cardiac Death

Author Affiliations
  • 1School of Medicine, University of California, San Francisco
  • 2Cardiac Electrophysiology Section, Division of Cardiology, Department of Medicine, University of California, San Francisco
JAMA Intern Med. 2021;181(8):1139-1140. doi:10.1001/jamainternmed.2021.3039

To the Editor We read with interest the article by Mohan et al,1 which reports that in the ORIGIN study, higher fish intake is associated with lower risk of sudden cardiac death (SCD) among patients with vascular disease, but not in general populations. The authors assert that possible “selective antiarrhythmic effects” of fish consumption may protect against SCD.1(p642) However, this article discusses neither how SCD was defined nor how cases were ascertained. In fact, none of the 4 contributing cohort studies clearly defines SCD. Rather, a variety of related terms are used, including “death from arrhythmia” and “cardiovascular death,” only some of which are defined. This raises concern regarding the utility and accuracy of the reported association.

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