A FIVE-YEAR RETROSPECTIVE AUTOPSY-BASED EPIDEMIOLOGICAL STUDY ON SUDDEN CARDIAC DEATH AT A TERTIARY CARE HOSPITAL IN WESTERN MAHARASHTRA
DOI:
https://doi.org/10.48165/jfmt.2024.41.1.4Keywords:
Sudden cardiac death, Coronary artery disease, Cardiovascular diseaseAbstract
Non-communicable diseases, which account for more than 60% of all deaths globally include Cardiovascular Disease (CVD), various cancers, chronic disorders, and diabetes. In India, the age-standardized CVD death rate is 272 per 100,000 people, which is much higher than the global average of 235. The aim of this five-year retrospective cross-sectional study carried out at a tertiary care hospital in Western Maharashtra from Oct 2018 to Oct 2023, is to understand the prevalence and etiology of sudden cardiac deaths. The data were obtained retrospectively from medico-legal autopsy reports and inquest papers, tabulated systematically and analysed statistically. During the study period, a total of 1200 post-mortems were conducted, out of which 24.83% of cases are of SCD. 22.82% of cases are of 51 to 60 years, and 75.84% are of males with a Male: Female ratio of 3:1. 74.83% are from urban areas with an Urban: Rural ratio of 3:1. 90.27% of SCDs are due to Coronary Artery Disease (CAD) while 57.05% of these cases have no comorbidities. Male preponderance of 44.97% is seen across all age groups and comorbidities. The prevalence of SCDs among adult males of 50 to 70 years is eyebrow raising in this part of the country. The etiology of SCDs is found to be multifactorial with or without a history of previous comorbidities present in the patients, with CAD being a major factor. Maintaining a healthy non sedentary lifestyle is the way forward to reduce the incidences of SCDs.
References
Kumar AS, Sinha N. Cardiovascular Disease In India: A 360 Degree Overview. Med J Armed Forces India. 2020 Jan;76(1):1-3.Doi: 10.1016/j.mjafi.2019.12.005
Global status report on non-communicable diseases 2014. Switzerland. World Health Organization; 2014. Accessed Nov 6, 2023. https://www.who.int/docs/ default-source/gho-documents/health-in-2015-mdgs to-sdgs/report-by-chapter/mdgs-sdgs2015- chapter6.pdf?sfvrsn=f72a3ade_2
Zipes DP, Libby P, Bonow RO, Braunwald E, Braunwald’s Heart Disease. A Textbook of Cardiovascular Medicine. 6th ed. Elsevier Saunders; 2005.
Prabhakaran D, Jeemon P, Roy A. Cardiovascular diseases in India: Current Epidemiology and Future Directions. Circulation. 2016 Apr 19; 133(16):1605– 1620. Doi: 10.1161/CIRCULATIONAHA.114.008729
Cardiovascular diseases (CVDs). World Health Organization; 2021. Accessed Nov 6, 2023. https:// www.who.int/health-topics/cardiovascular diseases#tab=tab_1
Kundu J, James KS, Hossain B, Chakraborty R. Gender Differences in Premature Mortality for Cardiovascular Disease in India, 2017–18. BMC Public Health .2023; 23:547. Doi: https://doi.org/ 10.1186/s12889-023-15454-9
Reddy KSN, Murty OP. The Essentials of Forensic Medicine & Toxicology. 34th ed. Jaypee; 2017.
Mumtaz A, Saeed A, Iftikhar A M, Sajid M, Azhar M. An Autopsy Study of Sudden Cardiac Death. J Pak Med Assoc. 2005 Apr;55(4):149-152. Accessed Nov 6 2023.
Virmani R, Burke AP, Farb A. Sudden cardiac death. Cardiovasc Pathol. 2001 Sept-Oct;10(5):211-218. Doi: https://doi.org/10.1016/S1054-8807(01)00091-6
Douglas P, Zipes, Hein J. J. W. Sudden Cardiac Death. Circulation. 1998; 98(21):2334-2351. Doi: https:// doi.org/10.1161/01.CIR.98.21.2334
Empana JP, Lerner I, Valentin E et al. Incidence of Sudden Cardiac Death in the European Union. J Am Coll Cardiol. 2022 May;79(18):1818–1827. Doi: 10.1016/j.jacc.2022.02.041
Lynge TH , Nielsen JL, Risgaard B, Christian V, Winkel BG, Hansen JT. Causes Of Sudden Cardiac Death According To Age And Sex In Persons Aged 1–49 Years. Heart Rhythm. 2023 Jan;20(1):1-68. Doi: https://doi.org/10.1016/j.hrthm.2022.08.036
Eckart RE, Shry EA, Allen P et al. Sudden Death in Young Adults An Autopsy-Based Series of a Population Undergoing Active Surveillance. J Am Coll Cardiol. 2011 Sep 13;58(12):1254-1261. Doi: 10.1016/ j.jacc.2011.01.049
Wisten A, Krantz P, Stattin EL. Sudden Cardiac Death Among the Young in Sweden from 2000 to 2010: An Autopsy-Based Study. Europace .2017;19(8): 1327– 1334. Doi: 10.1093/europace/euw249
Rao BH, Sastry BKS, Chugh SS et al. Contribution Of Sudden Cardiac Death To Total Mortality In India — A Population-Based Study. Int J Cardiol. 2012 Jan 26;154(2):163-167. Doi: 10.1016/j.ijcard.2010.09.016
Parkash R, Wightman H, Miles G et al. Primary Prevention of Sudden Cardiac Death With Device Therapy in Urban and Rural Populations.Can J Cardiol. 2017 Apr;33(4):437-442. Doi: https://doi.org/ 10.1016/j.cjca.2016.10.020
Lokhandwala Y, Panicker GK, Deshpande S. Sudden Cardiac Death-An Indian Perspective. CVD Prevention and Control.2009 Jun;4(2):103-108. Doi: https://doi.org/10.1016/j.cvdpc.2009.02.004
Ha FJ, Han HC, Sanders P et al. Sudden Cardiac Death in the Young-Incidence, Trends, and Risk Factors in a Nationwide Study. Circ Cardiovasc Qual Outcomes.2020;13:e006470. Doi: 10.1161/ CIRCOUTCOMES.119.006470
Wei H, Zhang LF, Wu YF et al. Incidence of Sudden Cardiac Death in China: Analysis of 4 Regional Populations. J Am Coll Cardiol. 2009 Sep;54 (12):1110–1118. Doi: 10.1016/j.jacc.2009.06.016.
Adabag AS, Luepker RV, Roger VL, Gersh BJ. Sudden Cardiac Death: Epidemiology And Risk Factors. Nat Rev Cardiol. 2010 Apr;7(4):216-225. Doi: 10.1038/nrcardio.2010.3.
Finocchiaro G, Radaelli D, D’Errico S et al. Sudden Cardiac Death Among Adolescents in the United Kingdom. J Am Coll Cardiol. 2023 Mar, 81 (11) 1007– 1017. Doi: 10.1016/j.jacc.2023.01.041
Park JH, Cha KC, Ro YS et al. Healthy Lifestyle Factors, Cardiovascular Comorbidities, And The Risk Of Sudden Cardiac Arrest: A Case-Control Study In Korea.Resuscitation.2022Jun;175:142-149. Doi:https:/ /doi.org/10.1016/j.resuscitation.2022.03.030
Sridharan A, Maron MS, Carrick RT et al. Impact Of Comorbidities On Atrial Fibrillation And Sudden Cardiac Death In Hypertrophic Cardiomyopathy. J of Cardiovas Electrophysiol. 2022; 33: 20 -29 https:// doi.org/10.1111/jce.15304
Jaramillo AP, Yasir M, Iyer N, Hussein S, Prabhu V. Sudden Cardiac Death: A Systematic Review. Cureus. 2023 15(8): e42859. DOI 10.7759/cureus.42859
Pan H, Hibino M, Kobeissi E, Aune D. Blood Pressure, Hypertension And The Risk Of Sudden Cardiac Death: A Systematic Review And Meta-Analysis Of Cohort Studies. Eur J Epidemiol. 2020May;35(5):443-454.Doi: 10.1007/s10654-019-00593-4
Saran R, Robinson B, Abbott KC, Et Al. US Renal Data System 2017 Annual Data Report: Epidemiology Of Kidney Disease In The United States. Am J Kidney Dis. 2018.71(3) :A7. Doi: 10.1053/j.ajkd.2018.01.002
Chugh SS, Reinier K, Teodorescu C et al. Epidemiology of Sudden Cardiac Death: Clinical and Research Implications. Prog Cardiovasc Dis.2008 Nov-Dec;51(3):213-28. Doi: 10.1016/j.pcad.2008.06.003
Stecker EC, Teodorescu C, Reinier K et al. Ischemic Heart Disease Diagnosed Before Sudden Cardiac Arrest Is Independently Associated With Improved Survival. J Am Heart Assoc. 2014 Oct 6;3(5):e001160. Doi: 10.1161/JAHA.114.001160
Gaspari MD, Rizzo S, Thiene G, Basso C. Causes Of Sudden Death. Eur Heart J Suppl.2023Apr21;25(SupplB):B16-B20 Doi: https:// doi.org/10.1093/eurheartjsupp/suad077
Vähätalo J, Holmström L, Pakanen L et al. Temporal Trends in the Incidence and Characteristics of Sudden Cardiac Death among Subjects under 40 Years of Age in Northern Finland during 1998–2017. Cardiology. 2022;147(3):328–331. Doi: https://doi.org/ 10.1159/000522554
