Thermogenic Supplement Use Does Not Alter Characteristics of Sudden Death in the Young
Background: To evaluate supplement use, most notably ephedra, which has been temporally associated with sudden death. Animal models suggest increased myocardial irritability may predispose to primary arrhythmic death. Methods: Clinical, pathological, and investigative records from the Office of the...
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Published in | Pacing and clinical electrophysiology Vol. 35; no. 11; pp. 1332 - 1337 |
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Main Authors | , , , , , |
Format | Journal Article |
Language | English |
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Malden, USA
Blackwell Publishing Inc
01.11.2012
Wiley |
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Abstract | Background: To evaluate supplement use, most notably ephedra, which has been temporally associated with sudden death. Animal models suggest increased myocardial irritability may predispose to primary arrhythmic death.
Methods: Clinical, pathological, and investigative records from the Office of the Armed Forces Medical Examiner's Cardiovascular Death Registry were reviewed. Forty‐eight cases of those with known supplement use were compared to 144 age‐, gender‐, and socioeconomic‐matched controls in a 1:3 case:control manner.
Results: Of the 48 sudden deaths temporally associated with supplement use, the mean age was 34.2 ± 10.0 years and predominantly male (n = 44, 91.7%). The underlying cause of death was fatal atherosclerotic coronary disease in 18 (37.5%), sudden unexplained death in 16 (33.3%), and hypertrophic cardiomyopathy in six (12.5%). Compared with controls, there were no statistically significant differences in adjudicated cause of death. On autopsy, there were no differences in cardiac mass, ventricular wall thickness, or presence of atherosclerosis in those known to be taking identified supplements compared to a control population. In the subject ≥35 years, and known to be taking supplements, there was a significant increase in causality of death as due to sudden unexplained death (relative risk = 5.1 [95% confidence interval, 1.4–18.7]).
Conclusions: Active surveillance of mortality in an autopsy‐derived series of young adults finds atherosclerotic coronary disease and idiopathic sudden death are common etiologies of death when taking supplements, but no cardiac structural or histologic mechanism to suggest different pathologic process than a matched control population. (PACE 2012; 35:1332–1337) |
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AbstractList | Background:
To evaluate supplement use, most notably ephedra, which has been temporally associated with sudden death. Animal models suggest increased myocardial irritability may predispose to primary arrhythmic death.
Methods:
Clinical, pathological, and investigative records from the Office of the Armed Forces Medical Examiner's Cardiovascular Death Registry were reviewed. Forty‐eight cases of those with known supplement use were compared to 144 age‐, gender‐, and socioeconomic‐matched controls in a 1:3 case:control manner.
Results:
Of the 48 sudden deaths temporally associated with supplement use, the mean age was 34.2 ± 10.0 years and predominantly male (n = 44, 91.7%). The underlying cause of death was fatal atherosclerotic coronary disease in 18 (37.5%), sudden unexplained death in 16 (33.3%), and hypertrophic cardiomyopathy in six (12.5%). Compared with controls, there were no statistically significant differences in adjudicated cause of death. On autopsy, there were no differences in cardiac mass, ventricular wall thickness, or presence of atherosclerosis in those known to be taking identified supplements compared to a control population. In the subject ≥35 years, and known to be taking supplements, there was a significant increase in causality of death as due to sudden unexplained death (relative risk = 5.1 [95% confidence interval, 1.4–18.7]).
Conclusions:
Active surveillance of mortality in an autopsy‐derived series of young adults finds atherosclerotic coronary disease and idiopathic sudden death are common etiologies of death when taking supplements, but no cardiac structural or histologic mechanism to suggest different pathologic process than a matched control population. (PACE 2012; 35:1332–1337) Background: To evaluate supplement use, most notably ephedra, which has been temporally associated with sudden death. Animal models suggest increased myocardial irritability may predispose to primary arrhythmic death. Methods: Clinical, pathological, and investigative records from the Office of the Armed Forces Medical Examiner's Cardiovascular Death Registry were reviewed. Forty‐eight cases of those with known supplement use were compared to 144 age‐, gender‐, and socioeconomic‐matched controls in a 1:3 case:control manner. Results: Of the 48 sudden deaths temporally associated with supplement use, the mean age was 34.2 ± 10.0 years and predominantly male (n = 44, 91.7%). The underlying cause of death was fatal atherosclerotic coronary disease in 18 (37.5%), sudden unexplained death in 16 (33.3%), and hypertrophic cardiomyopathy in six (12.5%). Compared with controls, there were no statistically significant differences in adjudicated cause of death. On autopsy, there were no differences in cardiac mass, ventricular wall thickness, or presence of atherosclerosis in those known to be taking identified supplements compared to a control population. In the subject ≥35 years, and known to be taking supplements, there was a significant increase in causality of death as due to sudden unexplained death (relative risk = 5.1 [95% confidence interval, 1.4–18.7]). Conclusions: Active surveillance of mortality in an autopsy‐derived series of young adults finds atherosclerotic coronary disease and idiopathic sudden death are common etiologies of death when taking supplements, but no cardiac structural or histologic mechanism to suggest different pathologic process than a matched control population. (PACE 2012; 35:1332–1337) To evaluate supplement use, most notably ephedra, which has been temporally associated with sudden death. Animal models suggest increased myocardial irritability may predispose to primary arrhythmic death. Clinical, pathological, and investigative records from the Office of the Armed Forces Medical Examiner's Cardiovascular Death Registry were reviewed. Forty-eight cases of those with known supplement use were compared to 144 age-, gender-, and socioeconomic-matched controls in a 1:3 case:control manner. Of the 48 sudden deaths temporally associated with supplement use, the mean age was 34.2 ± 10.0 years and predominantly male (n = 44, 91.7%). The underlying cause of death was fatal atherosclerotic coronary disease in 18 (37.5%), sudden unexplained death in 16 (33.3%), and hypertrophic cardiomyopathy in six (12.5%). Compared with controls, there were no statistically significant differences in adjudicated cause of death. On autopsy, there were no differences in cardiac mass, ventricular wall thickness, or presence of atherosclerosis in those known to be taking identified supplements compared to a control population. In the subject ≥35 years, and known to be taking supplements, there was a significant increase in causality of death as due to sudden unexplained death (relative risk = 5.1 [95% confidence interval, 1.4-18.7]). Active surveillance of mortality in an autopsy-derived series of young adults finds atherosclerotic coronary disease and idiopathic sudden death are common etiologies of death when taking supplements, but no cardiac structural or histologic mechanism to suggest different pathologic process than a matched control population. |
Author | APPEL, DAVID A. REICH, STEPHEN S. SHRY, ERIC A. ECKART, ROBERT E. MCNEAR, JENNIFER A. GENTLESK, PHILIP J. |
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Keywords | supplements Cardiocirculatory arrest Arrhythmia arrhythmias Heart disease Sudden death Cardiovascular disease sudden cardiac death |
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Dilemmas in nomenclature characterizing hypertrophic cardiomyopathy and left ventricular hypertrophy publication-title: Circ Cardiovasc Genet – year: 2003 – volume: 27 start-page: 1317 year: 2004 end-page: 1320 article-title: Inappropriate implantable cardioverter defibrillator discharge following consumption of a dietary weight loss supplement publication-title: Pacing Clin Electrophysiol – volume: 44 start-page: 171 year: 1994 end-page: 174 article-title: Myocardial infarction, hyperkalaemia and ventricular tachycardia in a young male body‐builder publication-title: Int J Cardiol – volume: 347 start-page: 2073 year: 2002 end-page: 2076 article-title: Botanical medicines—The need for new regulations publication-title: N Engl J Med – volume: 138 start-page: 468 year: 2003 end-page: 471 article-title: The relative safety of ephedra compared with other herbal products publication-title: Ann Intern Med – volume: 59 start-page: 494 year: 2007 end-page: 496 article-title: Weight loss supplement provoked idiopathic ventricular tachycardia publication-title: Indian Heart J – volume: 2 start-page: 1277 year: 2005 end-page: 1282 article-title: Sudden death in the young publication-title: Heart Rhythm – volume: 75 start-page: 175 year: 1999 end-page: 176 article-title: Atrial flutter in a young man with a highly competitive and stressful occupation publication-title: Postgrad Med J – volume: 291 start-page: 216 year: 2004 end-page: 221 article-title: Electrocardiographic and hemodynamic effects of a multicomponent dietary supplement containing ephedra and caffeine: A randomized controlled trial publication-title: JAMA – volume: 164 start-page: 495 year: 1999 end-page: 501 article-title: Dietary supplement use in U.S. Army Special Operations candidates publication-title: Mil Med – volume: 1 start-page: 3 year: 1987 end-page: 14 article-title: Myocarditis. 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Snippet | Background: To evaluate supplement use, most notably ephedra, which has been temporally associated with sudden death. Animal models suggest increased... To evaluate supplement use, most notably ephedra, which has been temporally associated with sudden death. Animal models suggest increased myocardial... Background: To evaluate supplement use, most notably ephedra, which has been temporally associated with sudden death. Animal models suggest increased... |
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SubjectTerms | Adult Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy arrhythmias Biological and medical sciences Cardiac dysrhythmias Cardiology. Vascular system Coronary Artery Disease - mortality Death, Sudden, Cardiac - epidemiology Dietary Supplements - utilization Drug-Related Side Effects and Adverse Reactions - mortality Emergency and intensive care: neonates and children. Prematurity. Sudden death Female Heart Humans Incidence Intensive care medicine Male Medical sciences Military Personnel - statistics & numerical data Plant Extracts - therapeutic use Registries Risk Factors sudden cardiac death supplements Survival Analysis Survival Rate United States - epidemiology |
Title | Thermogenic Supplement Use Does Not Alter Characteristics of Sudden Death in the Young |
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