4.5 Article

Sudden cardiac death in patients with coronary heart disease and antemortem alcohol intake A STROBE - compliant retrospective study

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MEDICINE
卷 101, 期 45, 页码 -

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LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MD.0000000000031396

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alcohol; coronary heart disease; forensic science; sudden death

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The present study aimed to assess the prevalence and causal relationship of alcohol intake prior to sudden cardiac death events in patients with coronary artery disease. The study found that in Lithuania, one out of every three sudden cardiac deaths in coronary artery disease patients had signs of antemortem alcohol consumption. Men and younger patients were more likely to consume alcohol, and alcohol positivity was more common during the winter months and holidays.
The present study was aimed to assess the prevalence and possible causal relationship of alcohol intake prior to a sudden cardiac death event in patients with coronary artery disease. The retrospective research was performed at the Vilnius branch of The State Forensic Medicine Service. The autopsy protocols for five years were analyzed and the cases of sudden cardiac death were selected, when the determined cause of death was Coronary Heart Disease (CHD), a forensic autopsy and toxicological blood and urine test had been performed. Cases of the sudden death of non-cardiac origin, cases of cardiomyopathy of various origins, and cases of acute cardiac arrest of unspecified origin were excluded. The data collected was processed using R software. The study sample consisted of 2133 cases. 706 (33%) CHD cases were alcohol positive. Males and young age CHD victims were more likely to find alcohol than females (72% vs. 28%, respectively, P < .001). The mean blood alcohol concentration of the sample was 1.37 parts per thousand +/- 1.01, urine's 1.73 parts per thousand +/- 1.29. Alcohol was more commonly found during the winter months and the holidays. Deaths in alcohol-positive individuals were more common in the alcohol elimination phase with hemodynamically insignificant coronary artery stenosis (up to 50% of arterial lumen). Nearly every third CHD victim in Lithuania who experienced sudden death also had signs of antemortem alcohol consumption.

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