Post-mortem toxicology in young sudden cardiac death victims: a nationwide cohort study
Post-mortem toxicology in young sudden cardiac death victims: a nationwide cohort study
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DOI：
10.1093/europace/euw435
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发表时间：
2018-04-01
期刊：
影响因子：
6.1
通讯作者：
Tfelt-Hansen, Jacob
中科院分区：
文献类型：
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作者：
Bjune, Thea;Risgaard, Bjarke;Tfelt-Hansen, Jacob
几种药物增加了心室颤动和心源性猝死（SCD）的风险。我们的目的是详细调查所有年轻的SCD在整个丹麦的毒理学研究结果。方法和结果死亡的人年龄在1-49岁，包括超过10年的时间。检索并阅读死亡证明和尸检报告，以确定猝死病例并确定死因。纳入了所有法医尸检SCD，并收集了毒理学报告。阳性毒理学定义为存在任何物质（合法和/或非法）。所有毒理学结果之前均被评价为不会导致死亡（即排除致死浓度）。我们确定了620例SCD法医尸检病例，其中77%（n = 477）进行了尸检毒理学研究，57%（n = 270）具有阳性毒理学特征。心源性猝死组中毒物学阳性者的猝死综合征（SADS）发生率高于毒物学阴性者（56% vs.42%，P < 0.01）。总共检测到752种药物，61%（n = 164）存在多种药物（定义为存在一种以上药物），所有物质合并。精神药物是最常见的（62%，n = 467），和82%（n = 385）是在药理学或亚药理学level.Conclusion，我们发现，超过一半的所有毒理学调查SCD受害者有积极的死后毒理学研究结果，并显示在相当大的比例多药。毒副反应阳性的SCD患者SADS发生率较高，提示化合物可能在这些病例中起预防作用。
Aims Several drugs increase the risk of ventricular fibrillation and sudden cardiac death (SCD). We aimed to investigate in detail the toxicological findings of all young SCD throughout Denmark.Methods and results Deaths in persons aged 1-49 years were included over a 10-year period. Death certificates and autopsy reports were retrieved and read to identify cases of sudden death and establish cause of death. All medico-legal autopsied SCD were included and toxicological reports collected. Positive toxicology was defined as the presence of any substance (licit and/or illicit). All toxicological findings had previously been evaluated not to have caused the death (i.e. lethal concentrations were excluded). We identified 620 medico-legal autopsied cases of SCD, of which 77% (n = 477) were toxicologically investigated post-mortem, and 57% (n = 270) had a positive toxicology profile. Sudden cardiac death with positive toxicology had higher rates of sudden arrhythmic death syndrome (SADS), compared with SCD with negative toxicology (56% vs. 42%, P < 0.01). In total, 752 agents were detected, and polypharmacy (defined as the presence of more than one drug) was present in 61% (n = 164), all substances combined. Psychotropic drugs were the most frequent (62%, n = 467), and 82% (n = 385) were in pharmacological or subpharmacological levels.Conclusion We found that more than half of all toxicologically investigated SCD victims have positive post-mortem toxicological findings, and polypharmacy is displayed in a considerable proportion. SCD with positive toxicology had higher rate of SADS, suggesting that the compounds may play a proarrhythmic role in these cases.