Toxicology Screening in Sports-Related Sudden Cardiac Death: A Multinational Observational Study.

Autor:	Hansen CJ; The Heart Centre, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark; Department of Forensic Medicine, University of Copenhagen, Copenhagen, Denmark. Electronic address: carl.johann.hansen@regionh.dk., Svane J; The Heart Centre, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark; Department of Forensic Medicine, University of Copenhagen, Copenhagen, Denmark., Palsøe MK; Department of Forensic Medicine, University of Copenhagen, Copenhagen, Denmark., Isbister JC; Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, University of Sydney, Sydney, Australia., Paratz E; Baker Heart and Diabetes Institute, Victoria, Australia., Molina P; Institute of Legal Medicine and Forensic Sciences, Valencia, Spain., Morentin B; Basque Institute of Legal Medicine, Bilbao, Spain; Department of Medical and Surgical Specialties, University of the Basque Country, UPV/EHU, Leioa, Bizkaia, Spain., Winkel BG; The Heart Centre, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark., La Gerche A; Baker Heart and Diabetes Institute, Victoria, Australia., Linnet K; Department of Forensic Medicine, University of Copenhagen, Copenhagen, Denmark., Banner J; Department of Forensic Medicine, University of Copenhagen, Copenhagen, Denmark., Lucena J; Institute of Legal Medicine and Forensic Sciences, Seville, Spain., Semsarian C; Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, University of Sydney, Sydney, Australia., Tfelt-Hansen J; The Heart Centre, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark; Department of Forensic Medicine, University of Copenhagen, Copenhagen, Denmark.
Jazyk:	angličtina
Zdroj:	JACC. Clinical electrophysiology [JACC Clin Electrophysiol] 2024 Mar; Vol. 10 (3), pp. 515-523. Date of Electronic Publication: 2023 Dec 20.
DOI:	10.1016/j.jacep.2023.11.006
Abstrakt:	Background: Knowledge of toxicological findings among sports-related sudden cardiac death (SrSCD) is scarce. Objectives: This study aimed to describe postmortem toxicology findings in a multinational cohort of young SrSCD. Methods: Patients with sudden cardiac death (SCD) aged 12 to 49 years with a complete post mortem were included from Denmark, Spain, and Australia. Postmortem findings were compared between SrSCD and non-SrSCD, and toxicology findings in SrSCD were assessed. Results: We included 3,189 SCD, of which 219 (7%) were sports-related. SrSCD patients were younger (36 years vs 41 years; P < 0.001) and of male predominance (96% vs 75%; P < 0.001), and their death was more often caused by structural cardiac disease (68% vs 61%; P = 0.038). Positive toxicology screenings were significantly less likely among SrSCD than non-SrSCD (12% vs 43%; P < 0.001), corresponding to 82% lower odds of a positive toxicology screening in SrSCD. Patient characteristics were similar between SrSCDs with positive and negative toxicology screenings, but deaths were more often unexplained (59% vs 34%). Nonopioid analgesics were the most common finding (3%), and SCD-associated drugs were detected in 6% of SrSCD. SUD was more prevalent among the SrSCD with positive toxicology (59% vs 34%). Conclusions: Sports-related SCD mainly occurred in younger men with structural heart disease. They had a significantly lower prevalence of a positive toxicology screening compared with non-SrSCD, and detection of SCD-associated drugs was rare. Competing Interests: Funding Support and Author Disclosures Dr Hansen has received support from the Augustinus Foundation, Danish Doctors Insurance Association, Christian and Ottilia Brorsons Foundation, and the Danish Cardiovascular Academy. Dr Semsarian is supported by a National Health and Medical Research Council (NHMRC) Investigator Grant (#2016822) and an NSW Health Cardiovascular Disease Clinician Scientist Grant. Dr Tfelt-Hansen is supported by research grants from Novo Nordisk Foundation and the John and Birthe Meyer Foundation. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu