Background: The clinical significance of coronary heart disease (CHD) as a potential cause of premature sudden cardiac death (SCD) has been reported. However, true prevalence of CHD in premature SCD remains unclear. We aim to identify the prevalence of CHD as a cause of premature SCD in Asian population.
Objective: To evaluate the prevalence of CHD in premature SCD in Asian population.
Methods: The medical examiner reports from Bangkok, Thailand, performed in Department of Forensic Pathology, Ramathibodi Hospital, Mahidol University, between January 2010 to December 2014, were reviewed. External causes, age under 18 or over 45 years old, malignancy, intoxication, and inconclusive autopsies were excluded. Premature SCD was defined as unexpected death due to a cardiac causes within 24 hours of being seen well in young adult under 45 years old. Conventional risk factors were reviewed among SCD and compared between coronary heart disease (CHD) and non-coronary heart disease (non-CHD).
Results: Among 1950 medical examiner reports, 80 cases (87.5% male, 37.7±5.5 years old) were considered as premature SCD from the full autopsy. The most common causes of premature SCD are coronary heart disease (CHD) followed by suggestive of cardiac arrhythmia and cardiomyopathy (45.2%, 22.3%, and 15% respectively). Left anterior descending coronary artery is the most common involved coronary artery in CHD followed by right coronary artery (83.3% and 44.4% respectively). Prevalence of double or triple vessel diseases similar to single vessel disease (55.6 vs 44.4%, p= 0.16). Male was prominent in CHD (94.4%) similar to non-CHD (81.8%). There was no difference in mean age and mean body mass index as well as prevalence of left ventricular hypertrophy among CHD and non-CHD.
Conclusions: The prevalence of CHD in premature SCD was very high up to 45.0% in Asian population. Early intervention for primary prevention of CHD in young adult under 45 years old should be considered.