Our recent paper,  ‘Prevalence of Coronary Artery Anomalies in Young and Middle-Aged Sudden Cardiac Death Victims’ examines the rate of coronary artery anomalies in the largest population of sudden cardiac death patients examined in Australia. From a population of approximately 1500 Victorians aged 1-50 years who experienced sudden cardiac arrest, over 700 underwent a comprehensive autopsy. A 1% rate of anomalies of coronary artery anatomy was identified, which is consistent with reported rates in angiographic, CT and other post-mortem series – this is reassuring that our dataset was representative of general findings.

However, within this 1% prevalence of coronary artery anomalies, not a single person had experienced their sudden cardiac arrest due to their coronary anomaly. All patients had clear alternative reasons for their death identified, such as another coronary artery occluded with acute thrombus, histological evidence of acute myocardial infarction or a ruptured thoracic aortic dissection.

This study is important, because it challenges earlier assumptions that coronary artery anomalies are a major cause of young sudden cardiac death. Early investigations into sudden cardiac death reported that coronary artery anomalies caused up to one-third of young sudden cardiac deaths. These studies included only a few dozen patients and were published several decades ago. However, citing these studies, both US and European guidelines have traditionally restricted participation in elite sport for patients with coronary anomalies.

Our dataset is not only the largest published in Australia, but also one of the largest in the world and our findings accord with contemporary figures from other major sudden cardiac death research teams. We hope that our data will prompt a re-appraisal and further investigations into the true role of coronary artery anomalies in young sudden cardiac death.

Summary by Dr Elizabeth Paratz

Available now as a preprint in The American Journal of Cardiology
Link to full article here:

 

Coronary Artery Anomalies in Young and Middle-Aged Sudden Cardiac Death Victims