Heart：冠脉疾病所致心源性猝死前常见心脏症状

　　丹麦一项研究表明，超过60%的心源性猝死年轻患者在死亡前出现心绞痛，并且有近半数冠脉疾病致死患者在死亡前1年内寻求医疗救助。论文于4月10日在线发表于《心脏》（Heart）。

　　此项病例对照研究共纳入314例经尸检证实的心源性猝死患者，其中13%（40例）因冠脉疾病死亡。以1:2的比例为冠脉疾病死亡患者建立年龄、性别相匹配的对照人群。对照者随机采样于1497例意外事故死亡者。通过患者登记系统评估受试者的医疗保健机构接触情况，并评阅包括死亡证明和尸检报告在内的可用患者记录。

　　结果显示，共有31例伴冠脉疾病的心源性猝死患者在死亡前12个月期间出现心脏症状，其中包括心绞痛（24例，62%）和呼吸困难。病例组的心脏症状发生率显著高于对照组（P<0.001）。病例组有18例患者（46%）在死亡之前因心脏症状而与保健保健机构联系；此比率亦显著高于对照组（P<0.001）。  

与猝死相关的拓展阅读：

• JACC：绝经后女性发生心源性猝死的相关危险因素
• J Am Heart Assoc：抑郁让猝死风险加倍
• JAMA：心肌纤维化是扩张型心肌病患者发生心源性猝死的独立预测因素
• JCE：ICD可用于预防心脏病瓣膜病患者的心脏病猝死
• 低血糖致猝死 心律失常或为始作俑者 更多信息请点击：有关猝死更多资讯

Cardiac symptoms before sudden cardiac death caused by coronary artery disease: a nationwide study among young Danish people.
OBJECTIVE
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).
METHODS
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.
RESULTS
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).
CONCLUSIONS
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.