Relationship of race to sudden cardiac death in competitive athletes with hypertrophic cardiomyopathy.
OBJECTIVE
The goal of this study was to determine the impact of race on identification of hypertrophic cardiomyopathy (HCM).


BACKGROUND
Sudden death in young competitive athletes is due to a variety of cardiovascular diseases (CVDs) and, most commonly, HCM. These catastrophes have become an important issue for African Americans, although HCM has been previously regarded as rare in this segment of the U.S. population.


METHODS
We studied the relationship of race to the prevalence of CVDs causing sudden death in our national athlete registry, and compared these findings with a representative multicenter hospital-based cohort of patients with HCM.


RESULTS
Of 584 athlete deaths, 286 were documented to be due to CVD at ages 17 +/- 3 years; 156 (55%) were white, and 120 (42%) were African American. Most were male (90%), and 67% participated in basketball and football. Among the 286 cardiovascular deaths, most were due to HCM (n = 102; 36%) or anomalous coronary artery of wrong sinus origin (n = 37; 13%). Of the athletes who died of HCM, 42 (41%) were white, but 56 (55%) were African American. In contrast, of 1,986 clinically identified HCM patients, only 158 (8%) were African American (p < 0.001).


CONCLUSIONS
In this autopsy series, HCM represented a common cause of sudden death in young and previously undiagnosed African American male athletes, in sharp contrast with the infrequent clinical identification of HCM in a hospital-based population (i.e., by seven-fold). This discrepancy suggests that many HCM cases go unrecognized in the African American community, underscoring the need for enhanced clinical recognition of HCM to create the opportunity for preventive measures to be employed in high-risk patients with this complex disease.
Maron
Barry J
BJ
Minneapolis Heart Institute Foundation, 920 East 28th Street, Suite 60, Minneapolis, MN 55407, USA. hcm.maron@mhif.org
Carney
Kevin P
KP
Lever
Harry M
HM
Lewis
Jannet F
JF
Barac
Ivan
I
Casey
Susan A
SA
Sherrid
Mark V
MV
D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications* / Q000208:ethnology* / Q000401:mortality; D002648:Child; D016757:Death, Sudden, Cardiac / Q000453:epidemiology / Q000208:ethnology* / Q000209:etiology*; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D012042:Registries / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013177:Sports / Q000706:statistics & numerical data*