The authors report no conflicts of interest, and have no financial disclosures to make as they apply to the research presented herein.
Thermogenic Supplement Use Does Not Alter Characteristics of Sudden Death in the Young
Article first published online: 4 SEP 2012
©2012, The Authors. No claim to original US government works
Pacing and Clinical Electrophysiology
Volume 35, Issue 11, pages 1332–1337, November 2012
How to Cite
APPEL, D. A., MCNEAR, J. A., SHRY, E. A., GENTLESK, P. J., REICH, S. S., ECKART, R. E. and for the Department of Defense Cardiovascular Death Registry Group (2012), Thermogenic Supplement Use Does Not Alter Characteristics of Sudden Death in the Young. Pacing and Clinical Electrophysiology, 35: 1332–1337. doi: 10.1111/j.1540-8159.2012.03510.x
- Issue published online: 7 NOV 2012
- Article first published online: 4 SEP 2012
- Received December 21, 2010; revised June 11, 2012; accepted June 18, 2012.
- sudden cardiac death;
Background: To evaluate supplement use, most notably ephedra, which has been temporally associated with sudden death. Animal models suggest increased myocardial irritability may predispose to primary arrhythmic death.
Methods: Clinical, pathological, and investigative records from the Office of the Armed Forces Medical Examiner's Cardiovascular Death Registry were reviewed. Forty-eight cases of those with known supplement use were compared to 144 age-, gender-, and socioeconomic-matched controls in a 1:3 case:control manner.
Results: Of the 48 sudden deaths temporally associated with supplement use, the mean age was 34.2 ± 10.0 years and predominantly male (n = 44, 91.7%). The underlying cause of death was fatal atherosclerotic coronary disease in 18 (37.5%), sudden unexplained death in 16 (33.3%), and hypertrophic cardiomyopathy in six (12.5%). Compared with controls, there were no statistically significant differences in adjudicated cause of death. On autopsy, there were no differences in cardiac mass, ventricular wall thickness, or presence of atherosclerosis in those known to be taking identified supplements compared to a control population. In the subject ≥35 years, and known to be taking supplements, there was a significant increase in causality of death as due to sudden unexplained death (relative risk = 5.1 [95% confidence interval, 1.4–18.7]).
Conclusions: Active surveillance of mortality in an autopsy-derived series of young adults finds atherosclerotic coronary disease and idiopathic sudden death are common etiologies of death when taking supplements, but no cardiac structural or histologic mechanism to suggest different pathologic process than a matched control population. (PACE 2012; 35:1332–1337)