B-PO04-156 TEMPORAL TRENDS IN THE INCIDENCE AND CHARACTERISTICS OF SUDDEN CARDIAC DEATH AMONG YOUNG IN NORTHERN FINLAND DURING 1998-2017

Although the mean age of sudden cardiac death (SCD) victims has increased during recent decades, overall incidence has remained relatively stable. Small but very important proportion of SCDs occur in subjects under 40 years of age and temporal trends in the incidence and characteristics of SCD in young are not well known. We aimed to investigate temporal trends in the incidence and characteristics among young SCD victims. The Fingesture study has prospectively gathered data from 5,869 consecutive autopsy verified SCD victims in Northern Finland during 1998-2017. On the basis of Finnish law, all subjects who die unexpectedly undergo autopsy. Determination of the cause of death was based on medicolegal autopsy, clinical records and questionnaires sent to the next of kin. The reference population in the Northern Finland for every 5-year period was used for incidence calculations. Out of total 5,869 SCDs during the period, 160 occurred in subjects under 40 years of age (2.7%) indicating a total incidence of 1.4/100 000. Incidence decreased during the study period; 2.1/100 000 in 1998-2002, 1.9/100 000 in 2003-2007, 1.3/100 000 in 2008-2012 and 0.7/100 000 in 2013-2017. Coronary artery disease (CAD) was the cause of death in 29% of young SCD victims. Among non-ischemic causes, most common were obesity related hypertrophic myocardial disease (24%), primary myocardial fibrosis (19%), hypertensive myocardial disease (6.3%), myocarditis (5%) and hypertrophic cardiomyopathy (4%). Structurally normal heart was present in 5 subjects (3%). Proportion of CAD as the cause of SCD decreased as follows; 38% in 1998-2002, 33% in 2003-2007, 22% in 2008-2012 and 14% in 2013-2017 (p=0.09). Proportion of male gender (81%) and obesity as a comorbidity (BMI >30 kg/m2, 40%) remained relatively stable during the period (p=0.58 and p=0.79, respectively). The incidence of SCD in young has decreased in Northern Finland during 1998-2017. Most of the deaths are due to non-ischemic myocardial diseases and relative proportion of CAD has decreased.