April 23, 2026Journal of the American College of Cardiology
Does sports activity enhance the risk of sudden death in adolescents and young adults?
Key result
Competitive sports in adolescents and young adults linked to ~150% higher sudden death risk vs non-athletes.
- RR 2.5
- 95% CI 1.8-3.4
- P<0.0001
- n=1,386,600
Why the study?
Little is known about the risk of sudden death in adolescents and young adults engaged in sports.
Does competitive sports activity increase the risk of sudden death in adolescents and young adults?
Population
Adolescents and young adults age 12 to 35 years averaging 1,386,600 in Veneto, Italy
Comparison
Competitive athletes vs non-athletes
Design
21-year prospective cohort study
Follow-up
21 years
Authors
Discussion
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Implication
May warrant intensified preparticipation screening for young athletes; leaves open whether sports triggers events or selects higher-risk individuals.
Key Points
- This research aims to evaluate the risk of sudden death in adolescents and young adults participating in sports.
- 21-year prospective cohort study in the Veneto Region of Italy
- Analyzed data from 1,386,600 adolescents and young adults, including 112,790 competitive athletes
- Gender-based analysis of sudden death risk and underlying causes in athletic and non-athletic groups.
- Incidence rate of sudden death was 1 in 100,000 per year in the overall cohort.
- 55 cases of sudden death occurred among athletes (2.3 per 100,000 per year) compared to 245 among non-athletes (0.9 per 100,000 per year).
- Higher risk of sudden death in athletes linked to cardiovascular diseases, with a relative risk of 2.5 for athletes.
Study Design
Type
Cohort (n=1,386,600)
Structured PICO
Does competitive sports activity increase the risk of sudden death in adolescents and young adults?
P
Population
Adolescents and young adults age 12 to 35 years in the Veneto Region of Italy. Total population averaged 1,386,600 (692,100 males and 694,500 females).
I
Intervention
Competitive sports activity (112,790 competitive athletes: 90,690 males and 22,100 females)
C
Comparator
Non-athletic population
O
Outcome
Sudden death (SD)hard clinical
Main Result
Effect estimate: RR 2.5 (95% CI 1.8-3.4)
Absolute Event Rate: 2.3% vs 0.9%
p-value: p=<0.0001
Competitive sports activity in adolescents and young adults is associated with a 2.5-fold increased risk of sudden death, primarily by triggering fatal arrhythmias in those with underlying cardiovascular conditions.
Cite This Study
Corrado et al. (2003) conducted a cohort in Sudden death (n=1,386,600). Competitive sports activity vs. Non-athletes was evaluated on Sudden death (RR 2.5, 95% CI 1.8-3.4, p=<0.0001). Competitive sports activity in adolescents and young adults was associated with an increased risk of sudden death compared to non-athletes (RR 2.5; 95% CI 1.8-3.4; p<0.0001).