July 21, 2014Heart157 citations
Incidence of sudden cardiac death in athletes: a state-of-the-art review
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Key Result
Athletes experience sudden cardiac death at rates between 1:40,000 and 1:80,000 in higher quality studies, with men, African-American/black athletes, and basketball players at higher risk.
Key Points
- To review the reported incidence of sudden cardiac death (SCD) in young athletes, evaluate methodological variations across studies, and determine an accurate incidence estimate.
- Searched PubMed for literature on SCD incidence in athletes and young populations aged up to 40 years.
- Evaluated 13 athlete studies (ages 9–40) and 15 non-athlete population studies (<40 years) for case identification methods, inclusion/exclusion criteria, and population denominator precision.
- Overall reported SCD rates varied across all studies from 1:917,000 to 1:3,000.
- Studies with higher methodological quality consistently estimated SCD incidence in the range of 1:40,000 to 1:80,000.
- Subgroup analyses identified higher risks of SCD among male athletes, African-American/Black athletes, and basketball players.
Structured PICO
P
Population
Athletes and young persons up to the age of 40 (based on 13 studies in athletes aged 9 to 40 and 15 studies in other populations under 40)
O
Outcome
Incidence rate of sudden cardiac death (SCD)hard clinical
The incidence of sudden cardiac death in athletes is likely higher than traditional estimates, which may necessitate the development of more effective prevention strategies.
Abstract
Sudden cardiac death (SCD) is the leading medical cause of death in athletes; however, the precise incidence is unknown. The objectives of this review were to examine studies on the rate of SCD in athletes, assess the methodological strengths and weaknesses used to arrive at estimates, compare studies in athletes with estimates in similar populations and arrive at an approximation of the incidence of SCD based on the best available evidence. A comprehensive literature search was performed in PubMed using key terms related to SCD in athletes. Articles were reviewed for relevance and included if they contained information on the incidence of SCD in athletes or young persons up to the age of 40. The reference list from each manuscript was reviewed for additional relevant articles. The methods for case identification were examined, as well as the inclusion and exclusion criteria and the precision of the population denominator studied. Thirteen studies were found investigating the rate of SCD in athletes who ranged in age from 9 to 40. An additional 15 incidence studies were located examining the rate of SCD in other populations under the age of 40. Rates of SCD varied from 1:917,000 to 1:3000. Studies with higher methodological quality consistently yielded incidence rates in the range of 1:40,000 to 1:80,000. Some athlete subgroups, specifically men, African-American/black athletes and basketball players, appear to be at higher risk. The incidence of SCD in athletes is likely higher than traditional estimates which may impact the development of more effective prevention strategies.