Afro-Caribbean male football players had a higher prevalence of major cardiac conditions associated with sudden cardiac death compared to non-Afro-Caribbean players (0.9% vs 0.42%, p<0.001).
Cross-Sectional (n=9,638)
Yes
Does Afro-Caribbean ethnicity and specific regional origin affect the prevalence of abnormal ECG/echocardiographic patterns and serious cardiac conditions in male professional football players?
Afro-Caribbean football players, particularly those of West African origin, have a significantly higher prevalence of abnormal ECG/echocardiographic findings and serious cardiac conditions associated with sudden cardiac death compared to non-Afro-Caribbean players.
Absolute Event Rate: 0.9% vs 0.42%
p-value: p=<0.001
Abstract Introduction Athletes of Afro-Caribbean (AC) ethnicity often show distinctive electrocardiogram (ECG) and echocardiographic patterns that overlap with cardiomyopathy. AC football players are at a higher risk of sudden cardiac death (SCD) than non-AC footballers. Evidence on regional differences with the African subcontinent is limited. This study investigated the electrical and structural characteristics of screened professional AC football players and reports the prevalence of serious disease compared with non-AC footballers in the UK. Methods Male football players who underwent pre-participation cardiovascular screening within the English Football Association (FA) programme between 2017-2024 were included. All players were categorised as AC or non-AC ethnicity (white or Asian) and were aged ≥16 years. Each player underwent a health questionnaire, 12-lead ECG and echocardiogram. African regions of origin were classified according to the United Nations geoscheme. T-wave inversion (TWI) was adjudicated per International Criteria, accounting for age and ethnicity. Clinical outcomes were assessed by expert sport cardiologists. Results 9,638 male football players including 2,907 (30.2%) AC players and 6,731 (69.8%) non-AC players were analysed. Among AC players, west African origin was the most common (1,518 52.2%), followed by Caribbean (916 31.5%), East African (211 7.3%), Central African (121 4.2%), North African (72 2.5%) and South African (69 2.4%). The distribution of TWI is presented in Figure 1. The presence of TWI in V1-V4 among AC vs non-AC players was 11.6% vs 1.2% (p0.001). Abnormal TWI was more common in AC players compared to non-AC players (5.1% vs. 2.2%; p0.001). Among AC players, those from central Africa demonstrated abnormal TWI most commonly (9.1%), compared to other regions (p0.05). This was followed by players from west Africa (5.7%), east Africa (4.3%), south Africa (4.3%), and the Caribbean (4.0%). Players from north Africa and non-AC players had a similar prevalence of abnormal TWI (1.4% vs. 2.2%; p=1.0). On echocardiogram, players from west Africa demonstrated a higher relative wall thickness (Table 1). Players of central and west African origin manifested a higher left ventricular mass compared to east/south/north African and Caribbean players. Major cardiac conditions associated with SCD were diagnosed in 25 AC players (0.9%) compared to 28 (0.42%) non-AC players (p0.001). Among AC players, 19 were from west Africa and 6 were Caribbean. Conclusion AC football players demonstrated a higher prevalence of abnormal TWI, increased RWT and increased mass compared to non-AC athletes. There was heterogeneity by region of origin within Africa. Athletes from west Africa harboured nearly three times more serious conditions associated with SCD. These findings support the use of a region-specific approach to refine risk stratification and improve diagnostic performance of cardiac screening.For image description, please refer to the figure legend and surrounding text. For image description, please refer to the figure legend and surrounding text.
Yamagata et al. (Mon,) conducted a cross-sectional in Pre-participation cardiovascular screening (n=9,638). Afro-Caribbean ethnicity vs. Non-Afro-Caribbean ethnicity (white or Asian) was evaluated on Major cardiac conditions associated with sudden cardiac death (p=<0.001). Afro-Caribbean male football players had a higher prevalence of major cardiac conditions associated with sudden cardiac death compared to non-Afro-Caribbean players (0.9% vs 0.42%, p<0.001).