Cardiac symptoms before sudden cardiac death caused by coronary artery disease: a nationwide study among young Danish people.
The aim of this nationwide case-control study was to identify and characterise symptoms before sudden death of young persons who had died due to coronary artery disease (CAD). We have previously investigated the incidence of sudden cardiac death (SCD) in young Danish people aged 1-35 years in Denmark during 2000-2006. We included all deaths (n=6629) and identified 314 autopsied cases of SCD, 40 of whom (13%) died from CAD. To compare symptoms before death, the CAD case group was sex- and age-matched 1:2 with a control group randomly sampled from a population of 1497 individuals who had died in accidents. We used data from the National Patient Registry on previous contacts with the healthcare system for all persons and read all available patient records, including death certificates and autopsy reports. A total of 31 (79%) persons with CAD-SCD had cardiac symptoms such as angina pectoris (n=24, 62%) and dyspnoea during the 12 months before death, and this was significantly higher than in the control group (p<0.001). In the case group, 18 persons (46%) had contacts with the healthcare system for cardiac symptoms before death, and this was also significantly higher than the control group (p<0.001). In this nationwide study we found that 62% of young persons with SCD experienced angina before death, and nearly half of them who died of CAD had sought medical attention within the last year before death.