University of Oulu

Vähätalo, J., Holmström, L., Pakanen, L., Kaikkonen, K., Perkiömäki, J., Huikuri, H., & Junttila, J. (2021). Coronary Artery Disease as the Cause of Sudden Cardiac Death Among Victims < 50 Years of Age. The American Journal of Cardiology, 147, 33–38.

Coronary artery disease as the cause of sudden cardiac death among victims < 50 years of age

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Author: Vähätalo, Juha1; Holmström, Lauri1; Pakanen, Lasse2,3;
Organizations: 1Research Unit of Internal Medicine, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
2Forensic Medicine Unit, Finnish Institute for Health and Welfare, Oulu, Finland
3Department of Forensic Medicine, Research Unit of Internal Medicine, Medical Research Center Oulu, University of Oulu, Oulu, Finland
4Biocenter Oulu, University of Oulu, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.4 MB)
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Language: English
Published: Elsevier, 2021
Publish Date: 2021-05-31


Coronary artery disease (CAD) is the most common cause of sudden cardiac death (SCD). Atherosclerosis increases with age, but also many victims of SCD in young and middle-aged population have CAD at autopsy. The purpose of this study was to determine the characteristics and autopsy findings of SCD due to CAD among victims of SCD under the age of 50. Fingesture is a population-based study consisting of consecutive series of victims of autopsy verified SCD in Northern Finland between the years 1998 to 2017 (n = 5,869). Histological examinations were part of all autopsies and a toxicology investigation was performed if needed. Analyses included information accumulated from death certificates, medical records, autopsy data, standardized questionnaire to the closest family members of the victims of SCD and police reports of the conditions of the death. Overall, 10.4% of all SCDs occurred among victims under the age of 50 years (610 victims). Most common underlying cause of SCD among these younger SCD victims was CAD (43.6%). The prevalence of CAD as the cause of SCD became more common in young SCD victims after the age of 35 years. The mean age of ischemic SCD victims was 44±5 years and most were men (89.5%). Most victims (90.2%) had no clinical diagnosis of CAD, however 33.8% had an autopsy evidence of silent myocardial infarction. SCD occurred during physical activity in 24.1%. Three-vessel disease was detected in 44.4% of the study victims. Cardiac hypertrophy (58.3%) and myocardial fibrosis (82.6%) were also common. At least 1 cardiovascular risk factor was present in 64.7% of SCD victims. In conclusion, most SCDs among victims < 50 years of age are due to CAD.

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Series: The American journal of cardiology
ISSN: 0002-9149
ISSN-E: 1879-1913
ISSN-L: 0002-9149
Volume: 147
Pages: 33 - 38
DOI: 10.1016/j.amjcard.2021.02.012
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
Funding: Sources of Funding: Aarne Koskelo Foundation, Finnish Foundation for Cardiovascular Research, the Finnish Medical Foundation, Instrumentarium Science Foundation, The Maud Kuistila Memorial Foundation, The Ida Montin Foundation, The University of Oulu Scholarship Foundation, Sigrid Juselius Foundation
Copyright information: © 2021 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (