This study evaluated sudden cardiac death (SCD) risk among the 2763 women with CAD who were enrolled in the Hormone and Estrogen Replacement Study (HERS). Over a mean follow-up of 6.8 years, SCD comprised 54% (136 events) of the cardiac-related deaths and 27% of all deaths. The following 6 predictors were independently associated with SCD and predicted incident events: myocardial infarction, heart failure, estimated glomerular filtration rate lower than 40 mL/min/1.73 m2, atrial fibrillation, physical inactivity, and diabetes. The incidences of SCD among women with 0 (n = 683), 1 (n = 1224), 2 (n = 610), and 3 or more (n = 246) risk factors at baseline were 0.3%, 0.5%, 1.2%, and 2.9% per year, respectively. The combination of clinical risk factors and left ventricular ejection function (C-index, 0.681) were better predictors of SCD than left ventricular ejection function alone (C-index, 0.600) and resulted in a 20% improvement in the net reclassification index (P < .001).