Sudden coronary death in Copenhagen city
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Acute ischemic heart disease (AIHD) affected 0.4% of Copenhagen residents, with 40-45% of cases resulting in sudden coronary death (SCD). Younger individuals were more prone to out-of-hospital SCD.
Area of Science:
- Cardiology
- Epidemiology
- Public Health
Background:
- Acute ischemic heart disease (AIHD) and sudden coronary death (SCD) represent significant public health challenges.
- Understanding the incidence, mortality, and patient characteristics associated with AIHD and SCD is crucial for developing effective prevention and intervention strategies.
Purpose of the Study:
- To investigate the occurrence and characteristics of AIHD and SCD in Copenhagen.
- To analyze factors influencing decision time for seeking medical help in patients experiencing cardiac symptoms.
Main Methods:
- Epidemiological investigations conducted in Copenhagen in 1968 and 1972-1973.
- Data collection on AIHD incidence, mortality, SCD rates, patient history, and decision-making time before seeking medical assistance.
Main Results:
- AIHD incidence was 0.4% with a 56% mortality rate; 40-45% of AIHD cases resulted in SCD.
- Patients experiencing SCD were less likely to have a prior history of ischemic heart disease (IHD) compared to those with AIHD without cardiac arrest.
- Decision time to seek medical help was longer for patients with a prior IHD history or prodromal symptoms, especially the elderly, and significantly longer for symptoms occurring between midnight and 8 a.m.
Conclusions:
- SCD constituted a substantial proportion of deaths in Copenhagen during the study period.
- Timeliness of seeking medical attention is influenced by prior IHD history, symptom presentation, and time of day.
- Younger individuals were found to be more susceptible to out-of-hospital SCD than the elderly.
Abstract:
In 1968 and 1972--1973 investigations in Copenhagen city were performed in order to acquire data concerning the occurrence of acute ischaemic heart disease (AIHD), including sudden coronary death (SCD). The incidence of AIHD was 0.4% with a total mortality of 56%. Of all patients with AIHD 40--45% terminated in SCD, being responsible for about a quarter of all deaths in Copenhagen city at that time. Patients suffering CSD had more seldom a previous history of ischaemic heart disease (IHD) than patients with AIHD not complicated by cardiac arrest/SCD. Patients with a previous history of IHD and/or prodromal symptoms had a longer decision time before calling a doctor or an ambulance than patients without such symptoms, especially the elderly. The decision time was neither affected by the day of the week nor the month of the year with regard to the occurrence of cardiac symptoms. On the other hand, the mean decision time was significantly longer if symptoms began between 12 midnight and 8 a.m. compared with the other times of the day. The study showed finally that younger people are more liable to die from SCD outside hospital than the elderly.