Characteristics of women with ischemic sudden cardiac death
AbstractBackground Sudden cardiac death (SCD) is a significant mode of death causing 15-20% of all deaths in high-income countries. Coronary artery disease (CAD) is the most common cause of SCD in both sexes, and SCD is often the first manifestation of underlying CAD in women. This case-control stud...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2023-12-01
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| Series: | Annals of Medicine |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/07853890.2023.2258911 |
| _version_ | 1797302163768082432 |
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| author | I. Hookana L. Holmström M. A. E. Eskuri L. Pakanen M. M. Ollila A. M. Kiviniemi T. Kenttä J. Vähätalo M. Tulppo E. S. Lepojärvi T. Piltonen J. Perkiömäki J. T. Tikkanen H. V. Huikuri M. J. Junttila |
| author_facet | I. Hookana L. Holmström M. A. E. Eskuri L. Pakanen M. M. Ollila A. M. Kiviniemi T. Kenttä J. Vähätalo M. Tulppo E. S. Lepojärvi T. Piltonen J. Perkiömäki J. T. Tikkanen H. V. Huikuri M. J. Junttila |
| author_sort | I. Hookana |
| collection | DOAJ |
| description | AbstractBackground Sudden cardiac death (SCD) is a significant mode of death causing 15-20% of all deaths in high-income countries. Coronary artery disease (CAD) is the most common cause of SCD in both sexes, and SCD is often the first manifestation of underlying CAD in women. This case-control study aimed to determine the factors associated with SCD due to CAD in women.Methods The study group consisted of women with CAD-related SCD (N = 888) derived from the Fingesture study conducted in Northern Finland from 1998 to 2017. All SCDs underwent medicolegal autopsy. The control group consisted of women with angiographically verified CAD without SCD occurring during the 5-year-follow-up (N = 610). To compare these groups, we used medical records, autopsy findings, echocardiograms, and electrocardiograms (ECGs).Results Subjects with SCD were older (73.2 ± 11.3 vs. 68.8 ± 8.0, p < 0.001) and were more likely to be smokers or ex-smokers (37.1% vs. 27.6%, p = 0.045) compared to control patients. The proportion of subjects with prior myocardial infarction (MI) was higher in controls (46.9% vs. 41.4% in SCD subjects, p = 0.037), but in contrast, SCD subjects were more likely to have underlying silent MI (25.6% vs. 2.4% in CAD controls, p < 0.001). Left ventricular hypertrophy (LVH) was more common finding in SCD subjects (70.9% vs. 55.1% in controls, p < 0.001). Various electrocardiographic abnormalities were more common in subjects with SCD, including higher heart rate, atrial fibrillation, prolonged QTc interval, wide or fragmented QRS complex and early repolarization. The prevalence of Q waves and T inversions did not differ between the groups.Conclusions Underlying LVH and previous MI with myocardial scarring are common and often undiagnosed in women with CAD-related SCD. These results suggest that untreated CAD with concomitant myocardial disease is an important factor in SCD in women. |
| first_indexed | 2024-03-07T23:31:45Z |
| format | Article |
| id | doaj.art-abc305fcfd444e3680003e96da069051 |
| institution | Directory Open Access Journal |
| issn | 0785-3890 1365-2060 |
| language | English |
| last_indexed | 2024-03-07T23:31:45Z |
| publishDate | 2023-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Annals of Medicine |
| spelling | doaj.art-abc305fcfd444e3680003e96da0690512024-02-20T11:58:25ZengTaylor & Francis GroupAnnals of Medicine0785-38901365-20602023-12-0155210.1080/07853890.2023.2258911Characteristics of women with ischemic sudden cardiac deathI. Hookana0L. Holmström1M. A. E. Eskuri2L. Pakanen3M. M. Ollila4A. M. Kiviniemi5T. Kenttä6J. Vähätalo7M. Tulppo8E. S. Lepojärvi9T. Piltonen10J. Perkiömäki11J. T. Tikkanen12H. V. Huikuri13M. J. Junttila14Research Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu and Biocenter Oulu, University of Oulu and Oulu University Hospital, Oulu, FinlandResearch Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu and Biocenter Oulu, University of Oulu and Oulu University Hospital, Oulu, FinlandResearch Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu and Biocenter Oulu, University of Oulu and Oulu University Hospital, Oulu, FinlandForensic Medicine Unit, Finnish Institute for Health and Welfare, Oulu, FinlandDepartment of Obstetrics and Gynecology, Research Unit of Clinical Medicine, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, FinlandResearch Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu and Biocenter Oulu, University of Oulu and Oulu University Hospital, Oulu, FinlandResearch Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu and Biocenter Oulu, University of Oulu and Oulu University Hospital, Oulu, FinlandResearch Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu and Biocenter Oulu, University of Oulu and Oulu University Hospital, Oulu, FinlandResearch Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu and Biocenter Oulu, University of Oulu and Oulu University Hospital, Oulu, FinlandResearch Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu and Biocenter Oulu, University of Oulu and Oulu University Hospital, Oulu, FinlandDepartment of Obstetrics and Gynecology, Research Unit of Clinical Medicine, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, FinlandResearch Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu and Biocenter Oulu, University of Oulu and Oulu University Hospital, Oulu, FinlandResearch Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu and Biocenter Oulu, University of Oulu and Oulu University Hospital, Oulu, FinlandResearch Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu and Biocenter Oulu, University of Oulu and Oulu University Hospital, Oulu, FinlandResearch Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu and Biocenter Oulu, University of Oulu and Oulu University Hospital, Oulu, FinlandAbstractBackground Sudden cardiac death (SCD) is a significant mode of death causing 15-20% of all deaths in high-income countries. Coronary artery disease (CAD) is the most common cause of SCD in both sexes, and SCD is often the first manifestation of underlying CAD in women. This case-control study aimed to determine the factors associated with SCD due to CAD in women.Methods The study group consisted of women with CAD-related SCD (N = 888) derived from the Fingesture study conducted in Northern Finland from 1998 to 2017. All SCDs underwent medicolegal autopsy. The control group consisted of women with angiographically verified CAD without SCD occurring during the 5-year-follow-up (N = 610). To compare these groups, we used medical records, autopsy findings, echocardiograms, and electrocardiograms (ECGs).Results Subjects with SCD were older (73.2 ± 11.3 vs. 68.8 ± 8.0, p < 0.001) and were more likely to be smokers or ex-smokers (37.1% vs. 27.6%, p = 0.045) compared to control patients. The proportion of subjects with prior myocardial infarction (MI) was higher in controls (46.9% vs. 41.4% in SCD subjects, p = 0.037), but in contrast, SCD subjects were more likely to have underlying silent MI (25.6% vs. 2.4% in CAD controls, p < 0.001). Left ventricular hypertrophy (LVH) was more common finding in SCD subjects (70.9% vs. 55.1% in controls, p < 0.001). Various electrocardiographic abnormalities were more common in subjects with SCD, including higher heart rate, atrial fibrillation, prolonged QTc interval, wide or fragmented QRS complex and early repolarization. The prevalence of Q waves and T inversions did not differ between the groups.Conclusions Underlying LVH and previous MI with myocardial scarring are common and often undiagnosed in women with CAD-related SCD. These results suggest that untreated CAD with concomitant myocardial disease is an important factor in SCD in women.https://www.tandfonline.com/doi/10.1080/07853890.2023.2258911Sudden cardiac deathsexwomencoronary artery diseaseautopsy |
| spellingShingle | I. Hookana L. Holmström M. A. E. Eskuri L. Pakanen M. M. Ollila A. M. Kiviniemi T. Kenttä J. Vähätalo M. Tulppo E. S. Lepojärvi T. Piltonen J. Perkiömäki J. T. Tikkanen H. V. Huikuri M. J. Junttila Characteristics of women with ischemic sudden cardiac death Annals of Medicine Sudden cardiac death sex women coronary artery disease autopsy |
| title | Characteristics of women with ischemic sudden cardiac death |
| title_full | Characteristics of women with ischemic sudden cardiac death |
| title_fullStr | Characteristics of women with ischemic sudden cardiac death |
| title_full_unstemmed | Characteristics of women with ischemic sudden cardiac death |
| title_short | Characteristics of women with ischemic sudden cardiac death |
| title_sort | characteristics of women with ischemic sudden cardiac death |
| topic | Sudden cardiac death sex women coronary artery disease autopsy |
| url | https://www.tandfonline.com/doi/10.1080/07853890.2023.2258911 |
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