Scientists at University of Oulu, Finland, have investigated the prevalence of coronary artery disease among sudden cardiac death victims under 50 years old.
The team at University of Oulu investigated the prevalence of coronary artery disease and autopsy findings and found that 44% of sudden cardiac deaths among people under the age of 50 were caused by coronary artery disease.
Coronary artery disease is the most common cause of sudden cardiac death at the demographic level. Although coronary artery disease is mainly considered to affect the older population, its significance among young people has now been recognised, too. In contrast to other causes of sudden cardiac death among young people, coronary artery disease is a preventable and treatable disease.
Investigating sudden cardiac deaths
The aim of the study was to examine the causes of sudden cardiac deaths among young and middle-aged people under the age of 50, as well as the typical characteristics of sudden deaths related to coronary artery disease and autopsy findings.
With this research, the group also aimed to assess the proportion of sudden cardiac death caused by coronary artery disease among different age groups and its occurrence over the past 20 years.
The group used the FinGesture data, which consists of all the deceased shown to have died from sudden cardiac death in a forensic autopsy in the region of Northern Finland in 1998–2017 (n = 5,869). Among this study population, a total of 610 victims (10%) were under the age of 50 and the majority of which were male (86%).
The team found that coronary artery disease was the most common cause of sudden cardiac death among people under the age of 50 (266 victims, 44%). The proportion of sudden deaths from coronary artery disease among all causes increased constantly by age group, being the lowest among those aged under 30 (7%) and the highest among those aged 45–50 (50%). Over the past 20 years, the proportion of sudden deaths from coronary artery disease among young people has decreased, which has also been previously observed for the entire population.
The majority (90%) of the victims of sudden death from coronary artery disease had not been diagnosed with coronary artery disease before their death. Nine out of ten of the victims were male. More than half of the young victims under the age of 50 years had at least one risk factor associated with cardiovascular diseases, which also highlights the importance of early screening and preventative measures among the younger population. For example, one third of the victims were known to be smokers. In addition to acquired risk factors, one third of the victims had a known case of sudden cardiac death in their family. A quarter of the victims had died during physical exertion.
The prevalence of advance coronary artery disease
A significant proportion of the victims in this study had an advanced coronary artery disease that was detectable in an autopsy. For example, triple-vessel coronary artery disease, cardiac fibrosis and cardiac hypertrophy were common findings in the autopsies of the young victims.
It is generally known that the development of coronary artery disease begins gradually at a young age. However, these current research findings suggest that coronary artery disease may be highly advanced despite the patient’s young age, which emphasises the need for early detection of coronary artery disease and the risk factors associated with it as well as the importance of screening among young adults.
Behind the study
The leader of this study, Juhani Junttila, is a cardiologist at Oulu University Hospital and a professor of cardiology. Junttila has been cited in over 5,000 times in scientific publications and he has authored over 120 international peer-reviewed publications.
Junttila was appointed as Associate Professor of Cardiology by University of Oulu in 2017 and a full Professor in 2018. Junttila has received several substantial grants and awards including the Leducq Foundation Transatlantic Fellowship in 2008 and Soisalo Young Investigator award from Finnish Foundation for Cardiovascular Research in 2014.
He graduated as a licentiate of medicine in 2007 and PhD in 2008 (University of Oulu). Prof Junttila started his research career in the beginning of his medical studies in 2002 in the research group lead by Professor Heikki Huikuri. During his PhD studies Prof Junttila worked as a visiting researcher in Masonic Medical Research Laboratory and Montreal Heart Institute.