Between 1998 and 2007, researchers in Finland performed postmortem examinations at the department of forensic medicine, University of Oulu. Causes of non-ischemic sudden cardiac death (SCD) were analyzed separately for those aged younger than 40 years, 40 to 59 years and older than 60 years. 

The study data were derived from 2,661 people who died of SCD. The autopsy data were combined with the hospital patient records and questionnaires completed by relatives of SCD victims to improve diagnostic accuracy.

According to results, CAD was the most prevalent cause of SCD (78.2%), whereas nonischemic causes of SCD were found in 579 of the 2,661 people who died of SCD (21.8%; mean age, 55 years; 78% men). More than 81% of nonischemic SCDs occurred in the home compared with ischemic SCDs (71%).

Of the 579 cases of non-ischemic SCD analyzed, fibrotic cardiomyopathy (28.3%) was the most prevalent underlying cause of non-ischemic SCD among those aged younger than 40 years. Alcoholic cardiomyopathy was the most common cause of death (25.8%) in those aged 40 to 59 years, and cardiomyopathy related to obesity was the most common cause of death in those aged older than 60 years.

“Population-based strategies to reduce obesity and heavy alcohol intake are one of the means to reduce the number of nonischemic SCDs. Research on reasons leading to myocardial fibrosis may be needed to further elucidate the mechanisms of this disease entity. The observations should be confirmed in other Western populations before the present results are generalized,” the researchers concluded.

http://www.heartrhythmjournal.com/article/S1547-5271(11)00786-7/abstract