Can post-mortem coronary artery calcium scores aid diagnosis in young sudden death?

Can post-mortem coronary artery calcium scores aid diagnosis in young sudden death?

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Item Type: Article
Status: Published
Official URL: https://doi.org/10.1007/s12024-020-00335-z
Journal or Publication Title: Forensic Science, Medicine and Pathology
Date: 2020
Divisions: Molecular Cardiology
Depositing User: General Admin
Identification Number: 10.1007/s12024-020-00335-z
ISSN: 1547-769X
Date Deposited: 03 Jan 2021 23:57
Abstract:

This study sought to explore the feasibility and utility of post-mortem coronary artery calcium (CAC) scoring in identifying patients with ischemic heart disease as cause of sudden death. 100 deceased patients aged 18–50 years underwent post-mortem examination in the setting of sudden death. At post-mortem, fifty cases were determined to have ischemic heart disease, and fifty had death attributed to trauma or unascertained causes. The CAC score was calculated in a blinded manner from post-mortem CTs performed on all cases. CAC scores were assessable in 97 non-decomposed cases (feasibility 97%). The median CAC score was 88 Agatston units [IQR 0–286] in patients deceased from ischemic heart disease vs 0 [IQR 0–0] in patients deceased from other causes (p < 0.0001). Presence of any coronary calcification differed significantly between ischemic heart disease and non-ischemic groups (adjusted odds ratio 10.7, 95% CI 3.2—35.5). All cases with a CAC score > 100 (n = 22) had ischemic heart disease as the cause of death. Fifteen cases had a CAC score of zero but severe coronary disease at post-mortem examination. Post-mortem CAC scoring is highly feasible. An elevated CAC score in cases 18–50 years old with sudden death predicts ischemic heart disease at post-mortem examination. However, a CAC score of zero does not exclude significant coronary artery disease. Post-mortem CAC score may be considered as a further assessment tool to help predict likely cause of death when there is an objection to or unavailability of post-mortem examination.

Creators:
Creators
Email
Paratz, Elizabeth D.
UNSPECIFIED
Costello, Ben
UNSPECIFIED
Rowsell, Luke
UNSPECIFIED
Morgan, Natalie
UNSPECIFIED
Smith, Karen
UNSPECIFIED
Thompson, Tina
UNSPECIFIED
Semsarian, Chris
UNSPECIFIED
Pflaumer, Andreas
UNSPECIFIED
James, Paul
UNSPECIFIED
Stub, Dion
UNSPECIFIED
La Gerche, André
UNSPECIFIED
Zentner, Dominica
UNSPECIFIED
Parsons, Sarah
UNSPECIFIED
Last Modified: 03 Jan 2021 23:57
URI: https://eprints.centenary.org.au/id/eprint/827

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