Analysis Of Related Risk Factors In Sudden Cardiogenic Death

Objective Sudden Cardiac Death (SCD) is usually referred to those unanticipated deaths caused by cardiac reasons. With or without past history of heart disease, it often occurred within 1 hour after the onset of acute symptoms. Most of SCD are caused by coronary atherosclerotic heart disease. The other causes include myocardial hypertrophy, diseases of myocardium, valvular heart disease, congenital heart disease, pulmonary embolism etc. The study of other related factors, such as gender, age, cardiac function, history of coronary heart disease, smoking, alcohol, hypertension, heredity could contribute to the prevention and treatment of SCD. The purpose of our study is to evaluate the risk factors of SCD of inpatients and to improve the preventive and treating effects of SCD.Method: This is an observing cohort study. Between January 1 of 2000 and December 31 of 2003, we enrolled inpatient deaths in cardiology department of 2nd hospital of Tianjin Medical University and divided these patients into two groups: SCD group and cardiac nonSD group. There were altogether 164 deaths ?male: 87, female:77, mean age:69, we divided these patients into two groups:1. SCD group:80, male:43, female:37, mean age:69, SCD in AMI:51. 2. Cardiac nonSD group:81, male:44. female:40, mean age:70, nonSD in AMI:30. We also enrolled the same time' s 747 acute myocardial infarction patients into survival group as control. So there are altogether 911 cases. Cardiac nonSD is referred to those cardiac deaths that excluded from SCD. We recorded thesepatients' risk fators, such as cardiac function, history of CAD, smoking, drinking and hypertension and lab results, biorhythm and ECG of death.Result: Comparison between SCD and Cardiac nonSD group(l)Comparison of mortality: There were altogether 164 deaths between January 1 of 2000 and December 31 of 2003. 48. 5% of them were SCD. In SCD deaths, coronary atherosclerotic heart disease accounted for 82. 5%, and most of them were acute myocardial infarction(AMI) patients(63. 75%),then old myocardial infarction patients(12. 5%). So AMI is the major cause of SCD in our department. (2)Comparison of related risk factors between SCD group and cardiac nonSD group. l)Age: The distribution of age in two groups were similar. Patients older than 65 yrs were more common: SCD group (71.25%), cardiac nonSD group (76. 74%)(P>0. 05). 2) Gender: Male:female=l. 16:1 in SCD group, and 1.10:1 in cardiac nonSD group(P>0. 05). 3) Biothythm of death: In SCD group, 31 patients' death occurred between 6Am and ll:59Am (38. 75%), 22. 5% of the patients' death occurred between 12:OOAm and 5:55Pm. There was no significant difference in cardiac nonSD group, and the comparison between the two groups showed significant difference(P<0. 05). 4) Biochemical parameters: a)CPK(U/L): CPK value (mean: 1948. 63) in SCD group was higher than cardiac nonSD group (mean:1139. 38) (P<0. 05), and had significant difference between the two groups. b)CK~MB (U/L) :CK~MB value (mean: 175. 72) in SCD group was higher than cardiac nonSD group (mean:92. 42) (P<0. 05) and had significant difference between the two groups. c)cTnI(U/L): cTnl value (mean:44. 23) in SCD group was higher than cardiac nonSD group (mean: 30. 71) (P<0. 05)and had significant difference between the two groups. 5)Ejection Fraction(EF):EF (mean:37. 44%) in SCD group was lower than cardiac nonSD group (mean:49. 7%) (P<0. 05).Comparison between the SCD group, cardiac nonSD group and survival group in AMI patients: 1)Mean age in survival group was 63, cardiac nonSD group was 73 and SCD group 71, The comparison between the three groups found out mean age in survival group was lower than SCD and cardiac nonSD group (P<0. 05) and there was no significant difference between SCD and cardiac nonSD group. 2)Gender: Male:female=l: 1. 32 in SCD group, 1:1.14 in cardiac nonSD group and 2.57:1 in survival group, there was no significant difference between the two groups. In these three groups, male proportion was higher than female in survival group, but there were more deaths in fema...