title: Specific characteristics of sudden death in a mediterranean Spanish population.
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.
authors.affiliation: Department of Cardiology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. msubiranad@santpau.cat
authors.forename: M Teresa
authors.initials: MT
authors.lastname: Subirana
authors.forename: Josep O
authors.initials: JO
authors.lastname: Juan-Babot
authors.forename: Teresa
authors.initials: T
authors.lastname: Puig
authors.forename: Joaquín
authors.initials: J
authors.lastname: Lucena
authors.forename: Antonio
authors.initials: A
authors.lastname: Rico
authors.forename: Manuel
authors.initials: M
authors.lastname: Salguero
authors.forename: Juan C
authors.initials: JC
authors.lastname: Borondo
authors.forename: Jorge
authors.initials: J
authors.lastname: Ordóñez
authors.forename: Josep
authors.initials: J
authors.lastname: Arimany
authors.forename: Rafael
authors.initials: R
authors.lastname: Vázquez
authors.forename: Lina
authors.initials: L
authors.lastname: Badimon
authors.forename: Gaetano
authors.initials: G
authors.lastname: Thiene
authors.forename: Antonio Bayés
authors.initials: AB
authors.lastname: de Luna
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D001344:Autopsy; D006332:Cardiomegaly / Q000150:complications; D002318:Cardiovascular Diseases / Q000097:blood / Q000150:complications* / Q000453:epidemiology / Q000473:pathology; D002648:Child; D003327:Coronary Disease / Q000150:complications; D016757:Death, Sudden, Cardiac / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology