Specific characteristics of sudden death in a mediterranean Spanish population

M. Teresa Subirana, Josep O. Juan-Babot, Teresa Puig, Joaquín Lucena, Antonio Rico, Manuel Salguero, Juan C. Borondo, Jorge Ordóñez, Josep Arimany, Rafael Vázquez, Lina Badimon, Gaetano Thiene, Antonio Bayés De Luna

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34 Citations (Scopus)

Abstract

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. © 2011 Elsevier Inc. All rights reserved.
Original languageEnglish
Pages (from-to)622-627
JournalAmerican Journal of Cardiology
Volume107
Issue number4
DOIs
Publication statusPublished - 15 Feb 2011

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