Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Apr 21;131(16):1384-91.
doi: 10.1161/CIRCULATIONAHA.114.011988. Epub 2015 Apr 6.

Sudden cardiac arrest during sports activity in middle age

Eloi Marijon  1 , Audrey Uy-Evanado  1 , Kyndaron Reinier  1 , Carmen Teodorescu  1 , Kumar Narayanan  1 , Xavier Jouven  1 , Karen Gunson  1 , Jonathan Jui  1 , Sumeet S Chugh  2
Affiliations

Sudden cardiac arrest during sports activity in middle age

Eloi Marijon et al. Circulation. .

Abstract

Background: Sports-associated sudden cardiac arrests (SCAs) occur mostly during middle age. We sought to determine the burden, characteristics, and outcomes of SCA during sports among middle-aged residents of a large US community.

Methods and results: Patients with SCA who were 35 to 65 years of age were identified in a large, prospective, population-based study (2002-2013), with systematic and comprehensive assessment of their lifetime medical history. Of the 1247 SCA cases, 63 (5%) occurred during sports activities at a mean age of 51.1±8.8 years, yielding an incidence of 21.7 (95% confidence interval, 8.1-35.4) per 1 million per year. The incidence varied significantly by sex, with a higher incidence among men (relative risk, 18.68; 95% confidence interval, 2.50-139.56) for sports SCAs compared with all other SCAs (relative risk 2.58; 95% confidence interval, 2.12-3.13). Sports SCA was also more likely to be a witnessed event (87% versus 53%; P<0.001) with cardiopulmonary resuscitation (44% versus 25%; P=0.001) and ventricular fibrillation (84% versus 51%; P<0.0001). Survival to hospital discharge was higher for sports-associated SCA (23.2% versus 13.6%; P=0.04). Sports SCA cases presented with known preexisting cardiac disease in 16% and ≥1 cardiovascular risk factors in 56%, and overall, 36% of cases had typical cardiovascular symptoms during the week preceding the SCA.

Conclusions: Sports-associated SCA in middle age represents a relatively small proportion of the overall SCA burden, reinforcing the idea of the high-benefit, low-risk nature of sports activity. Especially in light of current population aging trends, our findings emphasize that targeted education could maximize both safety and acceptance of sports activity in the older athlete.

Keywords: death, sudden; exercise; heart arrest; ventricular fibrillation.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Panel A – Proportion of patients with return of spontaneous circulation and survival to hospital discharge, according to sudden cardiac arrest (SCA) occurring during sports or not during sports; Panel B – Odds ratio for survival to hospital discharge of Sports SCA compared to Non-Sports SCA (crude and adjusted for age, sex, initial rhythm, response time, presence of witness, bystander cardiopulmonary resuscitation, ventricular fibrillation). Error bars indicate upper 95% confidence interval.
Figure 1
Figure 1
Panel A – Proportion of patients with return of spontaneous circulation and survival to hospital discharge, according to sudden cardiac arrest (SCA) occurring during sports or not during sports; Panel B – Odds ratio for survival to hospital discharge of Sports SCA compared to Non-Sports SCA (crude and adjusted for age, sex, initial rhythm, response time, presence of witness, bystander cardiopulmonary resuscitation, ventricular fibrillation). Error bars indicate upper 95% confidence interval.
Figure 2
Figure 2
Distribution of Cardiovascular Abnormalities Associated With Sudden Cardiac Arrest (SCA) in the 1,247 Subjects, According to Sports SCA (Upper Pie, N=63) and Non-Sports SCA (Lower Pie, N=1,184).
See this image and copyright information in PMC

Comment in

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Fishman GI, Chugh SS, Dimarco JP, Albert CM, Anderson ME, Bonow RO, Buxton AE, Chen PS, Estes M, Jouven X, Kwong R, Lathrop DA, Mascette AM, Nerbonne JM, O’Rourke B, Page RL, Roden DM, Rosenbaum DS, Sotoodehnia N, Trayanova NA, Zheng ZJ. Sudden cardiac death prediction and prevention: report from a National Heart, Lung, and Blood Institute and Heart Rhythm Society Workshop. Circulation. 2010;122:2335–2348. - PMC - PubMed
    1. Roger VL, Go AS, Lloyd-Jones DM, Benjamin EJ, Berry JD, Borden WB, Bravata DM, Dai S, Ford ES, Fox CS, Fullerton HJ, Gillespie C, Hailpern SM, Heit JA, Howard VJ, Kissela BM, Kittner SJ, Lackland DT, Lichtman JH, Lisabeth LD, Makuc DM, Marcus GM, Marelli A, Matchar DB, Moy CS, Mozaffarian D, Mussolino ME, Nichol G, Paynter NP, Soliman EZ, Sorlie PD, Sotoodehnia N, Turan TN, Virani SS, Wong ND, Woo D, Turner MB. Heart disease and stroke statistics--2012 update: a report from the American Heart Association. Circulation. 2012;125:e2–e220. - PMC - PubMed
    1. Harmon KG, Asif IM, Klossner D, Drezner JA. Incidence of Sudden Cardiac Death in National Collegiate Athletic Association Athletes. Circulation. 2011;123:1594–1600. - PubMed
    1. Maron BJ, Doerer JJ, Haas TS, Tierney DM, Mueller FO. Sudden deaths in young competitive athletes: analysis of 1866 deaths in the United States, 1980–2006. Circulation. 2009;119:1085–1092. - PubMed
    1. Drezner JA, Levine BD, Vetter VL. Reframing the debate: Screening athletes to prevent sudden cardiac death. Heart Rhythm. 2013;10:454–455. - PubMed

Publication types

MeSH terms