More effective actions required to prevent sudden cardiac deaths
Despite significant advancements in cardiology over the past decades, approximately 4 to 5 million people worldwide still die suddenly each year, with the majority of these deaths attributed to heart diseases. Two-thirds of cardiac arrests occur at home, and half of these incidents occur unwitnessed. Consequently, survival rates are extremely poor, with less than 10 % in most parts of the world. Experts predict that coronary artery disease will increase particularly in low- and middle-income countries in the future increasing the global incidence of sudden cardiac death.
The Lancet Commission, consisting of 30 medical specialists, now demands bolder and more innovative global collaboration to prevent sudden cardiac deaths. They propose integrating artificial intelligence and large dataset analysis methods to anticipate and identify risks of harmful cardiac events.
The report also suggests establishing cardiac arrest patient registries across the globe. These registries would promote research and support health policy decisions. The expert group emphasizes the swift initiation of first aid measures during cardiac arrests and comprehensive rehabilitation in survivors.
According to Professor Juhani Junttila, a Finnish member of the team and a professor at the University of Oulu, sudden cardiac death is a multifactorial event where heart disease prevention plays a significant role from a young age. "Most autopsies related to sudden deaths reveal heart diseases that had not been detected during the person's lifetime."
Finland Leads in Investigating Sudden Deaths' Causes
The commission underscores the importance of autopsies in collecting information about sudden deaths, and Finland has been a pioneer in this field for a long time. "According to Finnish law, a forensic autopsy is performed on those who die suddenly to determine the cause of death, while in most parts of the world, this practice is not common. As a result, factors contributing to sudden death, such as hereditary diseases, often remain undiscovered," explains Junttila.
In Finland, sudden cardiac death accounts for approximately 10-20% of all deaths. The majority of these cases are related to coronary artery disease. Each year, Finland experiences 4,000 to 5,000 sudden cardiac deaths stemming from coronary artery disease. About three-quarters of sudden cardiac deaths result from the disease of the heart's arteries, while the rest are associated with anomalies in the heart muscle or electrical channels, which are more common in younger individuals and likely hereditary.
"It still remains challenging to identify individuals at risk of sudden cardiac arrest. Currently, intervening in traditional risk factors for coronary artery disease, such as elevated cholesterol or blood pressure, smoking, and diabetes, is probably the most effective way to reduce sudden deaths," says Junttila.
Led by Professor Juhani Junttila, a cardiology research group has utilized the unique Fingesture dataset collected at the University of Oulu and Oulu University Hospital. This dataset includes information about individuals who, based on forensic autopsy, died of sudden cardiac death in Northern Finland from 1998 to 2017. In total, the Fingesture study has gathered data on nearly 6,000 victims of sudden cardiac death.