Sudden Cardiac Death in National Collegiate Athletic Association Athletes: A 20-Year Study.

Autor:	Petek BJ; Sports Cardiology Program, Knight Cardiovascular Institute, Oregon Health and Science University, Portland (B.J.P.).; Division of Cardiology (B.J.P., T.W.C., A.L.B.), Massachusetts General Hospital, Boston.; Cardiovascular Performance Program (B.J.P., T.W.C., A.L.B.), Massachusetts General Hospital, Boston., Churchill TW; Division of Cardiology (B.J.P., T.W.C., A.L.B.), Massachusetts General Hospital, Boston.; Cardiovascular Performance Program (B.J.P., T.W.C., A.L.B.), Massachusetts General Hospital, Boston., Moulson N; Division of Cardiology and Sports Cardiology BC, University of British Columbia, Vancouver, Canada (N.M.)., Kliethermes SA; Department of Orthopedics and Rehabilitation, University of Wisconsin Madison (S.A.K.)., Baggish AL; Division of Cardiology (B.J.P., T.W.C., A.L.B.), Massachusetts General Hospital, Boston.; Cardiovascular Performance Program (B.J.P., T.W.C., A.L.B.), Massachusetts General Hospital, Boston.; Swiss Olympic Medical Center, Lausanne University Hospital (CHUV), Switzerland (A.L.B.).; Institute for Sport Science, University of Lausanne (ISSUL), Switzerland (A.L.B.)., Drezner JA; Department of Family Medicine and Center for Sports Cardiology, University of Washington, Seattle (J.A.D., D.M.S., L.S., M.Z.S., K.G.H.)., Patel MR; Division of Cardiology, Duke Heart Center, and Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC (M.R.P.)., Ackerman MJ; Department of Molecular Pharmacology & Experimental Therapeutics, Windland Smith Rice Sudden Death Genomics Laboratory (M.J.A.), Mayo Clinic, Rochester, MN.; Department of Cardiovascular Medicine, Division of Heart Rhythm Services, Windland Smith Rice Genetic Heart Rhythm Clinic (M.J.A.), Mayo Clinic, Rochester, MN.; Department of Pediatric and Adolescent Medicine, Division of Pediatric Cardiology (M.J.A.), Mayo Clinic, Rochester, MN., Kucera KL; Department of Exercise and Sport Science, University of North Carolina at Chapel Hill (K.L.K.)., Siebert DM; Department of Family Medicine and Center for Sports Cardiology, University of Washington, Seattle (J.A.D., D.M.S., L.S., M.Z.S., K.G.H.)., Salerno L; Department of Family Medicine and Center for Sports Cardiology, University of Washington, Seattle (J.A.D., D.M.S., L.S., M.Z.S., K.G.H.)., Zigman Suchsland M; Department of Family Medicine and Center for Sports Cardiology, University of Washington, Seattle (J.A.D., D.M.S., L.S., M.Z.S., K.G.H.)., Asif IM; Family and Community Medicine, The University of Alabama at Birmingham Heersink School of Medicine (I.M.A.)., Maleszewski JJ; Department of Laboratory Medicine & Pathology (J.J.M.), Mayo Clinic, Rochester, MN., Harmon KG; Department of Family Medicine and Center for Sports Cardiology, University of Washington, Seattle (J.A.D., D.M.S., L.S., M.Z.S., K.G.H.).
Jazyk:	angličtina
Zdroj:	Circulation [Circulation] 2024 Jan 09; Vol. 149 (2), pp. 80-90. Date of Electronic Publication: 2023 Nov 13.
DOI:	10.1161/CIRCULATIONAHA.123.065908
Abstrakt:	Background: Understanding the incidence, causes, and trends of sudden cardiac death (SCD) among young competitive athletes is critical to inform preventive policies. Methods: This study included National Collegiate Athletic Association athlete deaths during a 20-year time frame (July 1, 2002, through June 30, 2022). Athlete deaths were identified through 4 separate independent databases and search strategies (National Collegiate Athletic Association resolutions list, Parent Heart Watch database and media reports, National Center for Catastrophic Sports Injury Research database, and insurance claims). Autopsy reports and medical history were reviewed by an expert panel to adjudicate causes of SCD. Results: A total of 143 SCD cases in National Collegiate Athletic Association athletes were identified from 1102 total deaths. The National Collegiate Athletic Association resolutions list identified 117 of 143 (82%), the Parent Heart Watch database or media reports identified 89 of 143 (62%), the National Center for Catastrophic Sports Injury Research database identified 63 of 143 (44%), and insurance claims identified 27 of 143 (19%) SCD cases. The overall incidence of SCD was 1:63 682 athlete-years (95% CI, 1:54 065-1:75 010). Incidence was higher in male athletes than in female athletes (1:43 348 [95% CI, 1:36 228-1:51 867] versus 1:164 504 [95% CI, 1:110 552-1:244 787] athlete-years, respectively) and Black athletes compared with White athletes (1:26 704 [1:20 417-1:34 925] versus 1:74 581 [1:60 247-1:92 326] athlete-years, respectively). The highest incidence of SCD was among Division I male basketball players (1:8188 [White, 1:5848; Black, 1:7696 athlete-years]). The incidence rate for SCD decreased over the study period (5-year incidence rate ratio, 0.71 [95% CI, 0.61-0.82]), whereas the rate of noncardiovascular deaths remained stable (5-year incidence rate ratio, 0.98 [95% CI, 0.94-1.04]). Autopsy-negative sudden unexplained death (19.5%) was the most common postmortem examination finding, followed by idiopathic left ventricular hypertrophy or possible cardiomyopathy (16.9%) and hypertrophic cardiomyopathy (12.7%), in cases with enough information for adjudication (118 of 143). Eight cases of death were attributable to myocarditis over the study period (1 case from January 1, 2020, through June 30, 2022), with none attributed to COVID-19 infection. SCD events were exertional in 50% of cases. Exertional SCD was more common among those with coronary artery anomalies (100%) and arrhythmogenic cardiomyopathy (83%). Conclusions: The incidence of SCD in college athletes has decreased. Male sex, Black race, and basketball are associated with a higher incidence of SCD. Competing Interests: Disclosures Dr Ackerman is a consultant for Abbott, Boston Scientific, Bristol Myers Squibb, Daiichi Sankyo, Invitae, Medtronic, Tenaya Therapeutics, Thryv Therapeutics, and UpToDate. Dr Ackerman and Mayo Clinic are involved in an equity/royalty relationship with AliveCor, Anumana, ARMGO Pharma, and Pfizer. None of these entities was involved in this study. Dr Baggish has received funding from the National Institute of Health/National Heart, Lung, and Blood Institute, the National Football Players Association, the American Heart Association, and the American Medical Society for Sports Medicine to study cardiovascular outcomes among elite athletes and receives compensation for his role as team cardiologist from the US Olympic Committee/US Olympic Training Centers, US Soccer, and US Rowing. Dr Drezner has received funding from the American Medical Society for Sports Medicine, the American Heart Association, and the National Center for Catastrophic Sports Injury Research. Dr Harmon has received funding from the American Medical Society for Sports Medicine, Football Research, Inc, the Pac-12, and the American Heart Association. Dr Kucera is supported by funds from the National Center for Catastrophic Sports Injury Research.
Databáze:	MEDLINE
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