Postmortem Evaluation of Adrenal and Other Endocrine Tumors in Patients With Sudden Death (SuddenDeath)

Helsinki University Central Hospital (HUCH)

Status: Active, not recruiting

Conditions: Adrenal Cushing Syndrome; Primary Aldosteronism; Endocrine Neoplasia; Pheochromocytoma

Treatments: Diagnostic Test: Adrenal aldosterone synthase (CYP11B2) staining; Diagnostic Test: Histopathological analysis; Diagnostic Test: Adrenal cortisol synthase (CYP11B1) staining

Study type: Observational

Funder types: Other

Identifiers

NCT05446779

THL/5008/5.05.00/2021

Details and patient eligibility

About

Sudden Cardiac Death is a leading cause of mortality and remains a major public health burden worldwide. Cardiac arrest due to coronary heart disease explains a large proportion of the cases, but if autopsy is not performed the exact underlying cause remains obscure in many adults who face sudden death outside heath care organizations. The investigators aim to find proof that primary aldosteronism is a risk factor for sudden death and to characterize the prevalence of adrenal pathology in sudden death of undetermined cause in a case-control study. In addition, the study aims to characterize the prevalence of other adrenal pathology i.e. silent adenomas, cortisol-producing adenomas and pheochromocytomas in sudden death. The investigators also seek evidence that other endocrine hormone overproduction-causing diseases are more prevalent in persons with sudden death compared with those experiencing traumatic or suicidal death sudden death.

Enrollment: 400 estimated patients

Sex: All

Ages: 35 to 70 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

Consecutive patients with out-of-hospital, sudden death

Exclusion criteria

1. Estimated time from death to refrigerator more than 24-48 hours and in the refrigerator time more than 7 days (susceptibility to excessive tissue breakdown)
2. Terminal disease
3. Institutionalized patients

Trial design

400 participants in 2 patient groups

Sudden death

Description:

Unexpected witnessed death occurring within an hour of the onset of symptoms in a person with or without previously known cardiac disease without an extra-cardiac cause, or unexpected unwitnessed death without extra-cardiac cause occurring in the previous 24 hours

Treatment:

Diagnostic Test: Adrenal aldosterone synthase (CYP11B2) staining

Diagnostic Test: Histopathological analysis

Diagnostic Test: Adrenal cortisol synthase (CYP11B1) staining

Control

Description:

Death because of an exogenic reason for sudden death such as trauma or suicide as a control group i.e. non-disease-induced sudden death

Treatment:

Diagnostic Test: Adrenal aldosterone synthase (CYP11B2) staining

Diagnostic Test: Histopathological analysis

Diagnostic Test: Adrenal cortisol synthase (CYP11B1) staining