In a scientific article published online earlier this week by Circulation, Eloi Marijon and colleagues at the Paris Cardiovascular Center reported on “Sports-Related Sudden Death in the General Population.”
In recent years there has been a focus on sudden cardiac death (SCD) that occurs in young athletes who are participants in organized and/or competitive sports. There has been much less attention paid to SCD that occurs in athletes (of all ages) who are not part of organized or competitive sports–those who are undertaking so-called recreational sporting activities. The investigators have studied the issue of SCD in this second, much larger group of athletes.
This large, observational study examined the experience in France between 2005 and 2010. The experience included 169,742,000 age specific person-years of follow-up. The investigators considered 2 separate groups:
1. Young athletes, ages 10-35, who were competitive athletes, and
2. Athletes, ages 10-75, who were participants in recreational sporting activities (cycling, jogging, soccer, hiking, swimming, basketball, and others).
Overall, the incidence of SCD was 4.6 per million population per year (860 events total). While a small number of SCD events (50) were observed in the first group, approximately 94% of the SCD events occurred in the group of recreational athletes. If the same statistics were applied to the United States population, we might expect upwards of 4250 cases of SCD among recreational athletes each year.
In the group of recreational athletes with SCD, only 11.7% had a known history of cardiovascular disease or had more than 1 classic risk factor for coronary heart disease. The majority of victims in this group were regular exercisers.
The exact cause of death among the victims was determined for only a minority (24.7%) of the group. If a cause of death was identified, it was cardiac-related in 98%.
The vast majority (93%) of SCD events were witnessed, but bystander CPR was provided in only one third of cases. Survival among the athletes with SCD was very much dependent upon prompt CPR and defibrillation.
The frequency of SCD among recreational athletes is probably much higher than previously thought. This issue deserves and probably will receive additional investigation. The information provided by this report should prompt or renew discussion about the availability of CPR and defibrillation (AED’s) at venues where recreational athletes participate in their sports.