Potential risk factors for sudden cardiac death: an analysis of medicolegal autopsy cases.
Chronic kidney disease and elevated serum C-reactive protein (CRP) have been suggested as clinical risk factors for cardiac attacks. The present study investigated postmortem blood urea nitrogen (BUN), creatinine (Cr) and CRP levels in the peripheral blood of sudden cardiac death cases. Adult autopsy cases of ischemic heart diseases (n=153, >20 years of age), including acute myocardial infarction (AMI, n=71), recurrent myocardial infarction (RMI, n=47), acute ischemic heart disease without infarction (AIHD, n=27) and chronic ischemic heart disease (CIHD, n=8), were examined and compared with chronic congestive heart disease (CHD, n=24), spontaneous cerebral hemorrhage (SCH, n=17) and mechanical asphyxiation (n=32). BUN was slightly higher for RMI and CHD, although Cr was slightly higher for SCH. CRP was higher for AMI than for AIHD. The correlation between BUN and Cr levels was significant for AMI, AIHD and CHD, but insignificant for RMI and CIHD. Heart weight was larger for all heart diseases and SCH than for asphyxiation, and was larger for RMI and CHD but lower for AIHD and CIHD among them. Body mass index (BMI) was slightly higher for AMI, RMI, AIHD and CHD, remaining within the reference interval in most cases, but was lower for CIHD. These findings suggest different risk factors or etiologies, including active atherosclerosis, latent renal failure, dehydration and cardiac hypertrophy, for sudden deaths due to these heart diseases.
Maeda
Hitoshi
H
Department of Legal Medicine, Osaka City University Medical School, Asahi-machi 1-4-3, Abeno, 545-8585 Osaka, Japan.
Michiue
Tomomi
T
Zhu
Bao-Li
BL
Ishikawa
Takaki
T
Quan
Li
L
Bessho
Yasumori
Y
Okazaki
Shuji
S
Kamikodai
Yasunobu
Y
Tsuda
Kohei
K
Komatsu
Ayumi
A
Azuma
Yoko
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001237:Asphyxia / Q000097:blood; D001806:Blood Urea Nitrogen; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis*; D002543:Cerebral Hemorrhage / Q000097:blood; D003324:Coronary Artery Disease / Q000150:complications; D003404:Creatinine / Q000097:blood*; D016757:Death, Sudden, Cardiac / Q000209:etiology*; D003681:Dehydration / Q000150:complications; D005260:Female; D049429:Forensic Pathology; D006333:Heart Failure / Q000097:blood; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000150:complications; D017380:Hypertrophy, Right Ventricular / Q000150:complications; D007674:Kidney Diseases / Q000150:complications; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000097:blood; D009206:Myocardium / Q000473:pathology; D009929:Organ Size; D012307:Risk Factors
D002097:C-Reactive Protein; D003404:Creatinine