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Alcohol, obesity identified as underlying causes of nonischemic sudden cardiac death
Hookana E. Heart Rhythm. 2011;8:1570-1575.
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New study results reveal underlying causes of nonischemic sudden cardiac death, including alcohol, obesity and myocardial fibrosis.
Between 1998 and 2007, researchers in Finland performed postmortem examinations at the department of forensic medicine, University of Oulu. Causes of nonischemic sudden cardiac death (SCD) were analyzed separately for those aged younger than 40 years, 40 to 59 years and older than 60 years. The study data were derived from 2,661 people who died of SCD. The autopsy data were combined with the hospital patient records and questionnaires completed by relatives of SCD victims to improve diagnostic accuracy.
According to results, CAD was the most prevalent cause of SCD (78.2%), whereas nonischemic causes of SCD were found in 579 of the 2,661 people who died of SCD (21.8%; mean age, 55 years; 78% men). More than 81% of nonischemic SCDs occurred in the home compared with ischemic SCDs (71%).
Of the 579 cases of nonischemic SCD analyzed, fibrotic cardiomyopathy (28.3%) was the most prevalent underlying cause of nonischemic SCD among those aged younger than 40 years. Alcoholic cardiomyopathy was the most common cause of death (25.8%) in those aged 40 to 59 years, and cardiomyopathy related to obesity was the most common cause of death in those aged older than 60 years.
“Population-based strategies to reduce obesity and heavy alcohol intake are one of the means to reduce the number of nonischemic SCDs. Research on reasons leading to myocardial fibrosis may be needed to further elucidate the mechanisms of this disease entity. The observations should be confirmed in other Western populations before the present results are generalized,” the researchers concluded.
Disclosure: The researchers report no relevant financial disclosures.
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Understanding the mechanisms of SCD in the general population is of paramount importance if we are ever going to arrive at efficient ways to prevent it. We know that ischemic heart disease predisposes [patients] to ventricular fibrillation, but we have only rudimentary knowledge about the reasons for SCD in younger individuals. This paper by Hookana et al sheds considerable light on the issue. The researchers point out the importance of obesity, alcohol abuse and fibrosis in younger SCD victims. Although the results come from a regional analysis, the study opens the door to new ideas about how to identify individuals at high risk so that we can ultimately prevent the calamity of sudden death.
– Peter Kowey, MD
Cardiology Today
Editorial Board member
Disclosure: Dr. Kowey reports no relevant financial disclosures.
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