Clinical and sociodemographic characteristics of sudden cardiac death victims in northen Tunisia
Keywords:
Sudden cardiac death; epidemiology; autopsy.Abstract
Background: The sudden cardiac death remains a major public health problem. This dramatic event has not been well investigated in Tunisia.
Aim:The aim of this work is to study the epidemiological and socio demographic characteristics of Tunisian victims.
Methods: We prospectively collected clinical, socio demographic and pathology data of victims of sudden cardiac death occurring in the northern Tunisia from October 2010 to September 2012. Results:The study population included 392 men and 108 women with a mean age of 52,2 + / - 15,8 years. Three quarters of the victims were sedentary, 57,9% were smoker and a family history of sudden death was identified in 9,8% of cases. Half of victims had a primary school education, only 8,4% has a university education, 65,6% of subjects lived in urban areas and 64% of victims were married. The vast majority of deaths had occurred either in a public place (41,4%) or at home (36,6%). The most frequent circumstance of death was at rest (67%). Only 5,1% of victims were transported by emergency medical services and 12,1% by civil protection. Ischemic heart disease was the leading cause of death with 267 cases; however a negative autopsy was denoted in 13,9% of victims.
Conclusions: Victims of sudden cardiac death in northern Tunisia were relatively young with a male predominance. Physical inactivity and smoking were the most common risk factors for cardiovascular disease. The majority of victims were married, had an urban origin and a low level of education. Ischemic heart disease was the first etiology of sudden death.
Downloads
References
Zipes DP, Wellens HJ. Sudden cardiac death. Circulation 1998;98:2334- 51
Turakhia M, Tseng ZH. Sudden cardiac death: epidemiology, mechanisms, and therapy. Curr Probl Cardiol 2007;32:501-46.
Seidl K, Senges J. Worldwide utilization of implantable cardioverter/defibrillators now and in the future. Card Electrophysiol Rev 2003;7:5-13
Ben Romdhane .H, Bougatef.S, Skhiri.H, et al.Le registre des maladies coronaires en Tunisie : organisation et premiers résultatsRev Epidemiol Sante Publique, 2004, 52 : 558-64
Basso C, Burke M, Fornes P et al. Guidelines for autopsy investigation of sudden cardiac death. Virchows Arch 2008;452:11-8
Cohle SD, Sampson BA. The negative autopsy: sudden cardiac death or other? Cardiovasc Pathol 2001;10:219-22.
Kannel WB, McGee DL. Epidemiology of sudden death: insights from the Framingham Study. Cardiovasc Clin 1985;15:93-105.
Albert CM, Mittleman MA, Chae CU et al. Triggering of sudden death from cardiac causes by vigorous exertion. N Engl J Med 2000;343:1355- 61.
Siscovick DS, LaPorte RE, Newman JM. The disease-specific benefits and risks of physical activity and exercise. Public Health Rep 1985;100:180-8.
Bartels R, Menges M, Thimme W. Effect of physical activity on incidence of sudden cardiac death. Study of the Berlin-Reinickendorf and BerlinSpandau population. Med Klin 1997;92:319-25.
Chiuve SE, Fung TT, Rexrode KM et al. Adherence to a low-risk, healthy lifestyle and risk of sudden cardiac death among women. JAMA 2011;306:62-9.
Rempher KJ. Cardiovascular sequelae of tobacco smoking. Crit Care Nurs Clin North Am 2006;18:13-20.
Goldenberg I, Jonas M, Tenenbaum A et al. Current smoking, smoking cessation, and the risk of sudden cardiac death in patients with coronary artery disease. Arch Intern Med 2003;163:2301-5.
Jouven X, Desnos M, Guerot C et al. Predicting sudden death in the population: the Paris Prospective Study I. Circulation 1999;99:1978-83.
Hallstrom AP, Cobb LA, Ray R. Smoking as a risk factor for recurrence of sudden cardiac arrest. N Engl J Med 1986;314:271-5
Balkau B, Jouven X, Ducimetiere P et al. Diabetes as a risk factor for sudden death. Lancet 1999;354:1968-9.
Albert CM, Chae CU, Grodstein F et al. Prospective study of sudden cardiac death among women in the United States. Circulation 2003;107:2096-101.
Matthews KA, Gump BB. Chronic work stress and marital dissolution increase risk of posttrial mortality in men from the Multiple Risk Factor Intervention Trial. Arch Intern Med 2002;162:309-15.
Helsing KJ, Szklo M. Mortality after bereavement. Am J Epidemiol 1981;114:41-52.
Dahabreh IJ, Paulus JK. Association of episodic physical and sexual activity with triggering of acute cardiac events: systematic review and meta-analysis. JAMA 2011;305:1225-33.
Kitamura A, Sato S, Naito Y et al. Trends in the incidence of cardiovascular diseases and risk factors among urban and rural Japanese males. Nihon Koshu Eisei Zasshi 2001;48:378-94.
Kucharska-Newton AM, Harald K, Rosamond WD et al. Socioeconomic indicators and the risk of acute coronary heart disease events: comparison of population-based data from the United States and Finland. Ann Epidemiol 2011;21:572-9.
Lown B. Sudden cardiac death: biobehavioral perspective. Circulation 1987;76:186-96.
Fornes P, Lecomte D, Nicolas G. Sudden coronary death outside of hospital; an comparative autopsy study of subjects with and without previous cardiovascular diseases. Arch Mal Coeur Vaiss 1994;87:319- 24.
Filippi A, Sessa E, Jr., Mazzaglia G et al. Out of hospital sudden cardiac death in Italy: a population-based case-control study. J Cardiovasc Med 2008;9:595-600.
Moore MJ, Glover BM, McCann CJ et al. Demographic and temporal trends in out of hospital sudden cardiac death in Belfast. Heart 2006;92:311-5.
Burke AP, Farb A, Malcom GT et al. Coronary risk factors and plaque morphology in men with coronary disease who died suddenly. N Engl J Med 1997;336:1276-82.
