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Sudden Cardiac Death in Young Adults: Environmental Risk Factors and Genetic Aspects of Premature Atherosclerosis

Authors

  • Maiken K. Larsen M.D.,

    1. Department of Forensic Medicine, Faculty of Health Sciences, Aarhus University, Brendstrupgaardsvej 100, 8200 Aarhus N, Denmark.
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  • Peter H. Nissen M.Sc., Ph.D.,

    1. Department of Clinical Biochemistry, Aarhus University Hospital, Tage Hansens Gade, 8000 Aarhus C, Denmark.
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  • Ingrid B. Kristensen M.D.,

    1. Department of Forensic Medicine, Faculty of Health Sciences, Aarhus University, Brendstrupgaardsvej 100, 8200 Aarhus N, Denmark.
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  • Henrik K. Jensen M.D., M.D.Sc., Ph.D.,

    1. Department of Cardiology, Aarhus University Hospital, Skejby, Brendstrupgaardsvej 100, DK-8200 Aarhus N, Denmark.
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  • Jytte Banner M.D., Ph.D.

    1. Department of Forensic Medicine, Faculty of Health Sciences, Aarhus University, Brendstrupgaardsvej 100, 8200 Aarhus N, Denmark.
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  • Presented at the 62nd Annual Meeting of the American Academy of Forensic Sciences, February 22–27, 2010, in Seattle, WA.

  • Supported by Research Grants from the Jørgen Møllers Foundation, Augustinus Foundation, Grosserer A. V. Lykfeldt and wife Foundation, Helga and Peter Kornings Foundation, Grosserer Valdemar Foersom and Thyra Foersom born Ottos Foundation, and Aarhus University.

Additional information and reprint requests:
Maiken Kudahl Larsen, M.D.
Department of Forensic Medicine
Faculty of Health Sciences
Aarhus University
Brendstrupgaardsvej 100
8200 Aarhus N
Denmark
E-mail: ml@forensic.au.dk

Abstract

Abstract:  Familial hypercholesterolemia (FH) is a genetic disorder that may lead to premature coronary heart disease (CHD) and sudden cardiac death (SCD). Mutations in the LDLR or APOB genes cause FH. We have screened the LDLR and the ligand-binding region of APOB genes in 52 cases of SCD. Deceased patients were younger than 40 years of age and were suspected of having FH. The LDLR and APOB genes were examined via PCR, high-resolution melting, and DNA sequencing. Therein, it was observed that 7.7% of the screened patients exhibited a rare sequence variant in the LDLR gene, with 5.7% suspected of being pathogenic mutations. Lipid profiles and genetic testing for FH could be considered when autopsy reveals significant atherosclerosis of the coronary arteries in young adults. First-degree family members are advised to seek medical advice and testing to determine their own risks of atherosclerosis to prevent premature CHD and SCD.

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