| Summary: | Background: The prevalence of obesity has increased significantly in Western Societies. Obesity increases the risk of sudden cardiac death (SCD), but the etiology and mechanisms of obesity-related SCD are unclear. Hypothesis: We hypothesized that obesity is associated with specific SCD characteristics which may explain the increased risk of SCD in obesity. Aims: We aimed to investigate the characteristics of SCD according to the BMI group. Methods: This study is derived from the FinGesture study, which has prospectively collected all out-of-hospital SCD cases from Northern Finland since 1998 (population ~700,000). As required by Finnish law, all sudden deaths undergo medicolegal autopsy, and the Fingesture study has included all sudden deaths from Northern Finland with autopsy-verified cardiac etiology (i.e., SCD). The determination of the cause of death was based on a combination of autopsy findings, medical records, and police and emergency medical service reports. Results: The study population consisted of a total of 5,869 autopsy-verified SCD victims. Mean age was 64.9±12.4 and 78.9 % were male. The mean age decreased along with increasing BMI class (Table) (p < 0.001). The proportion of non-ischemic cardiac disease (p < 0.001, Figure) and the mean heart weight at autopsy (p < 0,001, Table) increased along with increasing BMI. Conclusions: Obesity-related SCD is associated with younger age and a higher proportion of non-ischemic cardiac disease with hypertrophy. These results suggest that early development of non-ischemic cardiac disease may contribute to obesity-related SCD.
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