In Reply We thank Kuku et al for their interest in our work.1 They raised important questions related to our article on the prevalence of silent myocardial infarction (SMI) in individuals who experienced sudden cardiac death (SCD) where the underlying cause of death was determined to be coronary artery disease (CAD).1 The forensic investigation protocol of cause of death among individuals who experience sudden death in Finland is regulated by law, and thus, the forensic autopsy protocol is unified between single forensic pathologists and also between centers.