Specific Characteristics of Sudden Death in a Mediterranean Spanish Population

• Published in: The American journal of cardiology 2011-02, Vol.107 (4), p.622-627
• Main Authors: Subirana, M. Teresa, MD, Juan-Babot, Josep O., MD, PhD, Puig, Teresa, MD, PhD, Lucena, Joaquín, MD, PhD, Rico, Antonio, MD, PhD, Salguero, Manuel, MD, PhD, Borondo, Juan C., MD, Ordóñez, Jorge, MD, PhD, Arimany, Josep, MD, PhD, Vázquez, Rafael, MD, PhD, Badimon, Lina, MD, PhD, Thiene, Gaetano, MD, de Luna, Antonio Bayés, MD, PhD
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Algorithms; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Autopsy; Biological and medical sciences; Cardiology; Cardiology. Vascular system; Cardiomegaly - complications; Cardiovascular; Cardiovascular disease; Cardiovascular Diseases - blood; Cardiovascular Diseases - complications; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - pathology; Child; Coronary Disease - complications; Death, Sudden, Cardiac - epidemiology; Death, Sudden, Cardiac - etiology; Death, Sudden, Cardiac - pathology; Emergency and intensive care: neonates and children. Prematurity. Sudden death; Female; Humans; Incidence; Intensive care medicine; Lipoproteins; Male; Medical sciences; Middle Aged; Mortality; Myocardial Infarction - complications; Risk Factors; Spain - epidemiology; Studies; Thrombosis
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2010.10.028

Most of the data reported on sudden cardiac death has been from studies of Anglo-Saxon patients. We conducted a study to ascertain the relation between sudden death (SD) and some epidemiologic, clinical, and biochemical parameters and to assess the coronary histopathologic aspects of subjects in a Spanish population who had died suddenly. A total of 204 subjects (86% men), aged 12 to 80 years (mean 54 ± 15), who had died from out-of-hospital natural SD were evaluated. Only 15% of subjects had been previously diagnosed with heart disease. Pathologic evidence of underlying cardiovascular disease was found in 90% of cases, with coronary heart disease (CHD) the most frequent (58%). The CHD was acute coronary thrombosis in 41% and a stable plaque with luminal narrowing of ≥75% in 59%. An old myocardial infarction was found in 31% of the SD victims. Cardiac hypertrophy was found in 48%, with no relation between the presence of cardiac hypertrophy and CHD. Patients with stable plaques had a greater heart weight than did those with acute coronary thrombosis (p = 0.02). Male gender, older age, smoking, and low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio of ≥3 were associated with CHD. A greater percentage of patients with an eroded and/or ruptured plaque than patients with a stable plaque were smokers. Only smoking and a low-density lipoprotein/high-density lipoprotein cholesterol ratio of ≥3 were associated with an eroded and/or ruptured plaque. In conclusion, compared with the findings from studies of Anglo-Saxon patients, a lower incidence of CHD and acute coronary thrombosis and a greater incidence of cardiac hypertrophy were found in SD victims of a Mediterranean Spanish population.