Distinct Sex-Associated Phenotypes of Sudden Cardiac Arrest Across Clinical, ECG, and Echocardiographic Domains: Replication in Two Communities and Comparison with the Framingham Heart Study

Background: Sex differences in sudden cardiac arrest (SCA) incidence and outcomes are well established, but risk stratification underperforms in women. It is important to delineate sex-specific patterns in SCA across clinical, electrocardiographic, and echocardiographic domains. Methods: We studied out-of-hospital SCA cases from the Oregon Sudden Unexpected Death Study (ORSUDS; Portland, 2002-2020; discovery) and Prediction of Sudden Death in Multi-Ethnic Communities (PRESTO; Ventura County, 2015-2024; external replication). Sex differences in 38 comorbidities, 19 ECG and 12 echocardiographic

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