Historique
Article de Périodique
Sudden cardiac death associated to substances of abuse and psychotropic drugs consumed by young people: A population study based on forensic autopsies (2019)
Auteur(s) :
MORENTIN, B. ;
CALLADO, L. F.
Année
2019
Page(s) :
23-28
Langue(s) :
Anglais
Domaine :
Alcool / Alcohol ; Autres substances / Other substances ; Drogues illicites / Illicit drugs ; Tabac / Tobacco / e-cigarette
Discipline :
PAT (Pathologie organique / Organic pathology)
Thésaurus géographique
ESPAGNE
Thésaurus mots-clés
JEUNE
;
COEUR
;
PATHOLOGIE ORGANIQUE
;
TOXICOLOGIE
;
MORTALITE
;
MEDECINE LEGALE
;
AUTOPSIE
;
ALCOOL
;
TABAC
;
COCAINE
;
PRODUIT ILLICITE
;
TOXICITE
;
ISCHEMIE
;
INFARCTUS
;
FACTEUR DE RISQUE
Résumé :
Background: Toxic substances are one of the main risk factors for sudden cardiac death (SCD) in young people. However, there is limited information about this matter based on clinical research. The aim of this study was to analyze the use of substances of abuse (legal and illicit) and prescribed psychotropic drugs in young people who died by SCD.
Methods: A population-based study performed in 15-35-year-olds who died by SCD in Biscay (Basque-Country) between 1991 and 2016. Cases were analyzed prospectively by a complete autopsy, toxicological and histopathological studies. A case was considered positive for exposure to cardiotoxic substances if smoking status was diagnosed or if toxicological analysis detected any drug associated with increased risk of SCD.
Results: There were 204 SCD; 98 (48%) were exposed to a cardiotoxic substance, including smoking status (n = 72) and/or positive toxicology (n?=?58). Illicit drugs (n = 29, mainly cannabis and cocaine), ethanol (n = 25), and prescribed psychotropic drugs (n = 11) were detected. Positive cases were more frequent in males than in females (54% vs. 19%). They were also more common in subjects who died by acute (86%) and chronic (71%) ischemic heart disease than in myocardial diseases (33%) and sudden arrhythmic death syndrome (36%). All positive cases of illicit drugs were males. Smoking status was very high in deaths due to acute ischemic heart disease.
Conclusions: The proportion of users of substances of abuse was unexpectedly high, even more prevalent than other cardiovascular risk factors. Toxic substances could play an important role as triggers of SCD in young people.
Highlights:
The presence of drugs of abuse is very high in young people's sudden deaths.
Substances of abuse play an important role as triggers of sudden death in males.
Substances of abuse represent a higher risk than cardiovascular factors.
Tobacco followed by alcohol, cannabis and cocaine are the main substances consumed.
Influence of tobacco and cocaine is mainly important for ischemic heart disease.
Methods: A population-based study performed in 15-35-year-olds who died by SCD in Biscay (Basque-Country) between 1991 and 2016. Cases were analyzed prospectively by a complete autopsy, toxicological and histopathological studies. A case was considered positive for exposure to cardiotoxic substances if smoking status was diagnosed or if toxicological analysis detected any drug associated with increased risk of SCD.
Results: There were 204 SCD; 98 (48%) were exposed to a cardiotoxic substance, including smoking status (n = 72) and/or positive toxicology (n?=?58). Illicit drugs (n = 29, mainly cannabis and cocaine), ethanol (n = 25), and prescribed psychotropic drugs (n = 11) were detected. Positive cases were more frequent in males than in females (54% vs. 19%). They were also more common in subjects who died by acute (86%) and chronic (71%) ischemic heart disease than in myocardial diseases (33%) and sudden arrhythmic death syndrome (36%). All positive cases of illicit drugs were males. Smoking status was very high in deaths due to acute ischemic heart disease.
Conclusions: The proportion of users of substances of abuse was unexpectedly high, even more prevalent than other cardiovascular risk factors. Toxic substances could play an important role as triggers of SCD in young people.
Highlights:
The presence of drugs of abuse is very high in young people's sudden deaths.
Substances of abuse play an important role as triggers of sudden death in males.
Substances of abuse represent a higher risk than cardiovascular factors.
Tobacco followed by alcohol, cannabis and cocaine are the main substances consumed.
Influence of tobacco and cocaine is mainly important for ischemic heart disease.
Affiliation :
Basque Institute of Legal Medicine, Bilbao, Spain