Potential risk factors for sudden cardiac death: An analysis of medicolegal autopsy cases

• Published in: Legal medicine (Tokyo, Japan) Japan), 2009-04, Vol.11, p.S263-S265
• Main Authors: Maeda, Hitoshi, Michiue, Tomomi, Zhu, Bao-Li, Ishikawa, Takaki, Quan, Li, Bessho, Yasumori, Okazaki, Shuji, Kamikodai, Yasunobu, Tsuda, Kohei, Komatsu, Ayumi, Azuma, Yoko
• Format: Article
• Language: English
• Subjects: Acute cardiac death; Adult; Aged; Aged, 80 and over; Asphyxia - blood; Blood Urea Nitrogen; Body Mass Index; C-reactive protein; C-Reactive Protein - analysis; Cerebral Hemorrhage - blood; Chronic kidney disease; Coronary Artery Disease - complications; Coronary lesion; Creatinine - blood; Death, Sudden, Cardiac - etiology; Dehydration - complications; Female; Forensic Pathology; Heart Failure - blood; Humans; Hypertrophy, Left Ventricular - complications; Hypertrophy, Right Ventricular - complications; Internal Medicine; Kidney Diseases - complications; Male; Middle Aged; Myocardial Ischemia - blood; Myocardium - pathology; Organ Size; Risk Factors
• ISSN: 1344-6223; 1873-4162
• DOI: 10.1016/j.legalmed.2009.01.004

Abstract Chronic kidney disease and elevated serum C-reactive protein (CRP) have been suggested as clinical risk factors for cardiac attacks. The present study investigated postmortem blood urea nitrogen (BUN), creatinine (Cr) and CRP levels in the peripheral blood of sudden cardiac death cases. Adult autopsy cases of ischemic heart diseases ( n = 153, >20 years of age), including acute myocardial infarction (AMI, n = 71), recurrent myocardial infarction (RMI, n = 47), acute ischemic heart disease without infarction (AIHD, n = 27) and chronic ischemic heart disease (CIHD, n = 8), were examined and compared with chronic congestive heart disease (CHD, n = 24), spontaneous cerebral hemorrhage (SCH, n = 17) and mechanical asphyxiation ( n = 32). BUN was slightly higher for RMI and CHD, although Cr was slightly higher for SCH. CRP was higher for AMI than for AIHD. The correlation between BUN and Cr levels was significant for AMI, AIHD and CHD, but insignificant for RMI and CIHD. Heart weight was larger for all heart diseases and SCH than for asphyxiation, and was larger for RMI and CHD but lower for AIHD and CIHD among them. Body mass index (BMI) was slightly higher for AMI, RMI, AIHD and CHD, remaining within the reference interval in most cases, but was lower for CIHD. These findings suggest different risk factors or etiologies, including active atherosclerosis, latent renal failure, dehydration and cardiac hypertrophy, for sudden deaths due to these heart diseases.