Use of psychotropic medication in victims of sudden cardiac death with nonischemic heart disease

Background: Nonischemic heart disease (NIHD) is the underlying pathology in about 20% of sudden cardiac deaths (SCDs). Psychotropic medication has been reported as a risk factor for SCD among patients with coronary artery disease, but similar information concerning NIHD is scarce.Objectives: We evaluated the use of psychotropic medication in victims of SCD due to NIHD and compared it to the general medication use in Finland.Method: Study population was derived from the Finnish Genetic Study of Arrhythmic Events (Fingesture) (n = 5,869, mean age 65 +/- 12, 79% males; 1,404 victims of SCD due to NIHD, mean age 57 +/- 13, 77% males). All deaths occurred in Northern Finland during 1998-2017. All victims underwent a medico-legal autopsy. Data on use of medication was defined using post-mortem toxicology results and patient records. Subjects with neither toxicological analysis nor information of medication use available were excluded. Information on general medication use was derived from Finnish Statistics on Medicines 2018 and presented as defined daily dose/1000 inhabitants/day.Results: Psychotropic medication was used by 579 (41%) subjects with NIHD, whereas in the general population only 12% were estimated to use psychotropics. The results were similar in subgroups of psychotropic medication: 27% vs 2.3% for benzodiazepines, 19% vs 7.5% for antidepressants and 18% vs 2.2% for antipsychotics.Conclusions: Use of psychotropic medication is common in victims of SCD due to NIHD compared to the general population.