Relation of Race to Electrocardiographic Patterns in Elite American Football Players
Key result
Black race linked to ~103% higher rate of abnormal ECG patterns in elite football players.
- RR 2.03
- 95% CI 1.56 to 2.64
- P<0.0001
- n=1,959
Why the study?
Race might influence electrocardiographic patterns in highly-trained athletes, but this has not been studied in a large biracial athletic population.
Is black race associated with a higher prevalence of abnormal electrocardiographic patterns in elite male American football players compared to white players?
Population
1,959 elite male American football players at NFL Invitational Camp from 2000 to 2005
Comparison
Black players vs white players vs other races
Design
Observational electrocardiographic analysis
Authors
Discussion
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Implication
Black race is an independent determinant of abnormal ECG patterns in highly-trained male American football players, highlighting the need to consider race during pre-participation cardiovascular screening.
Key Points
- To establish electrocardiographic profiles and assess the influence of race on ECG alterations in highly trained American football players.
- Analyzed 12-lead ECGs from 1,959 elite male athletes participating in the National Football League Invitational Camp between 2000 and 2005.
- Categorized players by race and playing position, with follow-up echocardiograms performed in a subset of 203 athletes (10%) to screen for structural heart disease.
- Abnormal ECG patterns were present in 25% (n=480) of athletes, occurring more often in Black players (30%, n=396) than in White players (13%, n=78) or other races (15%, n=6; p < 0.0001).
- Distinctly abnormal ECG patterns suggestive of cardiac disease were significantly more prevalent in Black athletes (6%, n=76) than White athletes (2%, n=11; p = 0.0005).
- Multivariable analysis identified Black race as an independent predictor of both abnormal ECGs (RR 2.03, 95% CI 1.56 to 2.64, p < 0.0001) and distinctly abnormal patterns (RR 2.59, 95% CI 1.18 to 5.67, p = 0.02), while echocardiograms showed no structural cardiac abnormalities.
Study Design
Type
Cross-Sectional (n=1,959)
Structured PICO
Is black race associated with a higher prevalence of abnormal electrocardiographic patterns in elite male American football players compared to white players?
P
Population
1,959 elite male American football players attending the NFL Invitational Camp, judged free of structural heart disease.
O
Outcome
Presence of abnormal electrocardiographic (ECG) patternssurrogate
Main Result
Relative Risk: 2.03 (95% CI 1.56–2.64)
Absolute Event Rate: 30% vs 13%
p-value: p=<0.0001
Black race is an independent determinant of abnormal ECG patterns in highly-trained male American football players, highlighting the need to consider race during pre-participation cardiovascular screening.
Cite This Study
Magalski et al. (2008) conducted a cross-sectional in Highly-trained American football players (n=1,959). Black race vs. White race was evaluated on Abnormal ECG patterns (RR 2.03, 95% CI 1.56 to 2.64, p=<0.0001). Black race was an independent predictor of abnormal ECG patterns compared to white race in elite male American football players (30% vs 13%; RR 2.03, 95% CI 1.56-2.64, p<0.0001).