Potential risk factors for sudden cardiac death: an analysis of medicolegal autopsy cases

Area of Science:

• Forensic Pathology
• Cardiovascular Pathology
• Clinical Chemistry

Background:

• Chronic kidney disease and elevated C-reactive protein (CRP) are potential risk factors for cardiac events.
• Biomarkers in postmortem blood may offer insights into causes of sudden cardiac death.

Purpose of the Study:

• To investigate postmortem blood urea nitrogen (BUN), creatinine (Cr), and CRP levels in sudden cardiac death cases.
• To compare these biomarkers across different causes of death, including ischemic heart diseases, congestive heart disease, cerebral hemorrhage, and mechanical asphyxiation.

Main Methods:

• Analysis of adult autopsy cases (n=233) categorized by cause of death.
• Measurement of postmortem peripheral blood levels of BUN, Cr, and CRP.
• Comparison of biomarker levels, heart weight, and body mass index (BMI) across groups.

Main Results:

• BUN levels were slightly elevated in recurrent myocardial infarction (RMI) and congestive heart disease (CHD).
• Creatinine (Cr) levels were slightly higher in spontaneous cerebral hemorrhage (SCH).
• CRP levels were higher in acute myocardial infarction (AMI) compared to acute ischemic heart disease without infarction (AIHD).
• Significant BUN-Cr correlation observed in AMI, AIHD, and CHD, but not in RMI or chronic ischemic heart disease (CIHD).
• Heart weight varied across disease groups, generally larger in heart diseases and SCH.
• BMI was slightly higher in AMI, RMI, AIHD, and CHD, but lower in CIHD.

Conclusions:

• Findings suggest distinct risk factors and etiologies for sudden cardiac death.
• Potential contributing factors include active atherosclerosis, latent renal failure, dehydration, and cardiac hypertrophy.
• Biomarker profiles may help differentiate causes of sudden cardiac death.