Alcohol Intake and Obesity Among Significant Cause of SCD Independent of Coronary Artery Disease

New population-based study published in HeartRhythm analyzes age-specific causes of sudden cardiac death in more than 2,600 victims

View the full study »

A new study results reveal underlying causes of nonischemic sudden cardiac death (SCD) — those causes not related to coronary artery disease (CAD) — including alcohol, obesity and myocardial fibrosis.

Published in the October 2011 edition of HeartRhythm, the official journal of the Heart Rhythm Society, the study also reinforces CAD as one of the most prevalent causes of SCD in the general population. Furthermore, the results establish specific causes of nonischemic SCD in different age groups, including people under the age of 40.

The study data were derived from a total of 2,661 SCD victims whose deaths occurred between 1998 and 2007. Based upon a population of 467,190 in the Province of Oulu (Finland) in the year 2007, the annual incidence of SCD was established at 56.9 deaths per 100,000 inhabitants — 0.06% per year. Nonischemic cause of SCD was found in 579 victims — 21.8% of all SCDs).

Between 1998 and 2007, postmortem examinations were performed at the Department of Forensic Medicine of the University of Oulu in Northern Finland. Causes of nonischemic SCD were analyzed separately for people younger than 40 years, between 40 and 59 years, and older than 60 years. The study data was derived from a total of 2,661 SCD victims whose death occurred based upon a population of 467,190.

The autopsy rate of victims of sudden, unexpected death in Finland is relatively high, allowing for large-scale, non-biased analysis of SCD causes. The autopsy data were combined with the hospital patient records and questionnaires completed by relatives of SCD victims to improve diagnostic accuracy.

Concurrent with previous studies, CAD was the most prevalent cause of SCD (78.2 percent), while nonischemic causes of SCD were found in 579 of the 2,661 victims (21.8 percent). Of the 579 victims analyzed, the most prevalent underlying causes of nonischemic SCD in the people under the age of 40 was fibrotic cardiomyopathy (CM), at 28.3 percent), whereas alcoholic CM was the most common cause of death between 40-59 years of age (25.8 percent) and CM related to obesity was the most common cause of death in people older than 60 (22.8%).

"As diagnosis and treatment methods evolve over time, it is important to always look for new ways to identify and attempt to reduce the occurrence of heart related deaths in the general population," stated co-author Heikki V. Huikuri, MD, Department of Internal Medicine Department at University of Oulu in Oulu, Finland. "The unique approach and novel findings of our study provides clinicians and patients with useful data about the potential causes of sudden cardiac death."

Changes in lifestyle patterns, decreased physical activity and socioeconomic development, have significantly changed in recent decades, ultimately affecting the incidence of SCD. Today, obesity has become a worldwide epidemic* and is often recognized as a risk for cardiac diseases. Additionally, it has been estimated that almost 4 percent of the global burden of disease is attributable to alcohol**. As shown through this study, strategies to reduce obesity and alcohol intake may help lower the number nonischemic SCDs.

 

*World Health Organization: Obesity: preventing and managing the global epidemic: report of a WHO Consultation on Obesity, Geneva, 3—5 June, 1997. Geneva: World Health Organization, 1998.

** Rehm J, Taylor B, Room R. Global burden of disease from alcohol, illicit drugs and tobacco. Drug Alcohol Rev 2006; 25:503—513.