Key result
Sudden cardiac death during physical exercise was more frequently associated with coronary artery disease (91% vs 75%, P<0.001) and myocardial scarring (59% vs 42%, P<0.001) compared to death at rest.
Why the study?
What are the characteristics and autopsy findings of subjects who experience sudden cardiac death during physical exercise compared to those who die at rest?
Observational (n=1,204)
What are the characteristics and autopsy findings of subjects who experience sudden cardiac death during physical exercise compared to those who die at rest?
Absolute Event Rate: 91% vs 75%
p-value: p=<0.001
Hypothesis-generating for CAD screening in active adults; extends autopsy data without establishing causality or practice change.
OBJECTIVE: To provide data on the risk factors and characteristics of subjects who experience sudden cardiac death (SCD) during physical exercise. METHODS AND RESULTS: We assessed the characteristics and the medico-legal autopsy findings of SCD victims who had experienced a witnessed fatal cardiac arrest at rest (n = 876) or in relation to physical exercise (n = 328) in the Finnish Study of Genotype and Phenotype Characteristics of SCD (FinGesture). A total of 876 (73%) witnessed SCDs occurred at rest (R group) and 328 (27%) during or immediately after physical exercise (PE group). Male gender was more common in the PE group compared to the R group (309/328, 94% versus 678/876, 77%, P < 0.001). Coronary artery disease was a more common structural heart disease than non-ischemic disease at autopsy when SCD was exercise-triggered (299/328, 91% versus 657/876, 75%, P < 0.001). Myocardial scarring and cardiac hypertrophy were more commonly found at autopsy in the PE group (194/328, 59% versus 370/876, 42%, P < 0.001; 243/328, 74% versus 585/876, 67%, P = 0.012, respectively). Skiing, cycling, and snow shoveling were the most common modes of exercise at the time of SCD. CONCLUSIONS: SCD during or immediately after exercise is related to male gender, ischemic heart disease, cardiac hypertrophy, and myocardial scarring.
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Toukola et al. (2015) conducted an observational in Sudden cardiac death (n=1,204). Physical exercise vs. Rest was evaluated on Coronary artery disease at autopsy (p=<0.001). Sudden cardiac death during physical exercise was more frequently associated with coronary artery disease (91% vs 75%, P<0.001) and myocardial scarring (59% vs 42%, P<0.001) compared to death at rest.
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