The majority of middle-aged victims of sudden coronary death have detectable signs of coronary disease years prior, highlighting opportunities for secondary prevention.
Baseline signs may flag high-risk men for closer monitoring; leaves open whether earlier intervention reduces sudden coronary deaths.
A total of 77 sudden coronary deaths (SCD) in men and seven in women occurred during a 6-year follow-up in a population comprising 6510 men and 5800 women aged 30-59 years in four areas of Finland. About 60% of all coronary deaths in men aged 40 and over were SCDs. The most common place of death was home; only six cases reached hospital. The most common time for SCD was at 7 a.m.-3 p.m. and the most common day was Friday. Deaths were evenly distributed over the year. At the time of the baseline study--3 1/2 years before death on an average--male SCD victims showed more symptoms and signs suggestive of coronary disease than those who suffered a non-sudden coronary death or a non-fatal myocardial infarction. More than half of the SCD victims had probable coronary disease at the time of the baseline study. Heart disease was a more common cause of death among the mothers of male SCD victims than among the adult Finnish female population as a whole. This study indicates that the majority of candidates for later SCD can be detected early enough for secondary prevention to be attempted.
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OLLI SUHONEN (1983) studied this question.
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