Abstract 18946: Frequency of Unidentified Cause of Death in Sudden Unexpected Death: A Post-mortem Retrospective Study From Asian Population

• Published in: Circulation (New York, N.Y.) Vol. 132; no. Suppl_3 Suppl 3; p. A18946
• Main Authors: Rattanawong, Pattara, Vutthikraivit, Wasawat, Kanjanahattakij, Napatt, Ngarmukos, Tachapong, Srisont, Smith
• Format: Journal Article
• Language: English
• Published: by the American College of Cardiology Foundation and the American Heart Association, Inc 10.11.2015
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.132.suppl_3.18946

IntroductionSudden unexpected death (SUD) is the leading cause of death worldwide. Although coronary atherosclerosis is a major cause of SUD, standard autopsy may not explain the cause of SUD. The frequency of unidentified cause of death in Thailand is not known. Therefore, we conduct a retrospective study to address the frequency of unidentified cause of death in SUD of Thailand.HypothesisThe frequency of unidentified cause of death in SUD of Thailand could be higher than Caucasian.MethodsWe reviewed autopsy reports of SUD in Ramathibodi Hospital, Mahidol University, Thailand, during January 2012-December 2013. The autopsy reports were excluded if; (1) the age was over 65 or under 18 years; (2) the death was expected deathe.g. the decease was in hospice care; (3) the cause was an obvious non-cardiac causee.g. trauma, overdose, or pneumonia; (4) the decease was not Thai citizen.ResultsA total of 116 cases, 108 males (93.1%) and 8 female (6.9%), were included. The mean age was 49.7±15.2 years. The cause of death was identified as ischemic heart disease in 74 cases (63.8%), which 32 cases (27.6%) were significant coronary atherosclerosis without infarction, 23 cases (19.8%) were acute myocardial infarction, and 19 cases (16.4%) were old myocardial scaring. The causes of death were due to myocardial bridging in 8 cases (6.9%), isolated left ventricular hypertrophy in 6 cases (5.2%), hypertrophic cardiomyopathy in 3 cases (2.6%), and myocarditis in 2 cases (1.7%). Other causes were 1 case (0.9%) of obesity cardiomyopathy, 1 case (0.9%) of aortic stenosis, and 1 case (0.9%) of dilated cardiomyopathy. Interestingly, the cause of death was not clearly identified in 20 cases (17.2%) from standard autopsy, including 5 cases (4.3%) without any co-morbidity, 6 cases (5.2%) with non-significant atherosclerosis, 4 cases (3.4%) with non-toxic level of prescribed drugs, 3 cases (2.6%) with non-toxic level of alcohol, and 2 cases (1.7%) with history of epilepsy.ConclusionsWe demonstrated higher frequency of unidentified cause of death in Thai SUD compared to Caucasian, as well as frequency of myocardial bridging. However, the frequency of ischemic heart disease was lower. Further incidence study and molecular autopsy of SUD should be conducted in Asian population.