The global challenge of sudden cardiac death in the new millennium. Summary of a Cuban study
Keywords:
cardiac sudden death, coronary occlusion, myocardial infarction, risk grade, atherosclerosisAbstract
Introduction and Objective: Ischemic heart disease causes millions of deaths worldwide and over 50% occur suddenly. The aim of this study was to describe the epidemiology of sudden cardiac death in populations of Havana, Cuba. Method: An observational and descriptive study of the aforementioned deaths due to biological causes over a period of 15 years (1995-2009) was conducted. The population studied was 210,000. Results: 9.6% of deaths from cardiac causes were sudden, and it predominated in patients aged 75 and older (35.4%). 6.8% occurred in individuals aged under 45 years, 53.9% were male and 45.6% were white. 63.0% of cardiac arrests were initiated outside the hospital. 54.4% of those who die suddenly from cardiac causes had a history of ischemic heart disease, 42.0% presented hypertension and 68.5% had coronary atherosclerotic lesions. Sudden cardiac death (54.2%) and myocardial infarction (31.2%) were the most frequent presumptive diagnoses and an acute coronary syndrome was confirmed in 36.3% of the deceased. Conclusions: One of every 10 natural cardiac deaths was sudden, and male, white persons; aged 75 and over were predominant as well as a prehospital occurrence of the event . A history of ischemic heart disease, hypertension and left ventricular hypertrophy were the predominant risk factors, and the main causes were acute myocardial infarction and cardiac arrhythmias. Coronary atherosclerotic lesions were identified in two thirds of the dead.
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