title: Incidence and etiology of sports-related sudden cardiac death in Denmark--implications for preparticipation screening.
abstract: BACKGROUND
  Studies on incidences of sports-related sudden cardiac death (SrSCD) are few and data are needed for the discussion of preparticipation screening for cardiac disease.
  
  
  OBJECTIVE
  We sought to chart the incidence and etiology of SrSCD in the young in Denmark (population 5.4 million) and to compare this to the incidence of sudden cardiac death (SCD) in the background population.
  
  
  METHODS
  All 5,662 death certificates for decedents in the period 2000 to 2006 in the age group 12 to 35 years in Denmark were read independently by 2 physicians to identify cases of SCD. Information from autopsy reports, selected hospital records, and multiple registries was used to identify cases of SCD and SrSCD. SrSCD was defined as SCD occurring during or within 1 hour after exercise in a competitive athlete. The size of the athlete population was estimated from national survey data.
  
  
  RESULTS
  Fifteen (range 0 to 5 per year) cases of SrSCD were found, 8 of which had antecedent symptoms. The incidence rate was 1.21 (95% confidence interval [CI]: 0.68 to 2.00) per 100,000 athlete person-years. The most common autopsy findings were arrhythmogenic right ventricular cardiomyopathy (n = 4), sudden unexplained death (n = 4), and coronary artery disease (n = 2). The incidence of SCD in the general population age 12 to 35 was 3.76 (95% CI: 3.42 to 4.14) per 100,000 person-years.
  
  
  CONCLUSIONS
  In Denmark, SrSCD is a rare occurrence and the incidence rate is lower than that of SCD in the general population. This may imply a low value of preparticipation screening of athletes in Denmark.
authors.affiliation: Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC), University of Copenhagen, Denmark. anders@kanten.dk
authors.forename: Anders Gaarsdal
authors.initials: AG
authors.lastname: Holst
authors.forename: Bo Gregers
authors.initials: BG
authors.lastname: Winkel
authors.forename: Juliane
authors.initials: J
authors.lastname: Theilade
authors.forename: Ingrid Bayer
authors.initials: IB
authors.lastname: Kristensen
authors.forename: Jørgen Lange
authors.initials: JL
authors.lastname: Thomsen
authors.forename: Gyda Lolk
authors.initials: GL
authors.lastname: Ottesen
authors.forename: Jesper Hastrup
authors.initials: JH
authors.lastname: Svendsen
authors.forename: Stig
authors.initials: S
authors.lastname: Haunsø
authors.forename: Eva
authors.initials: E
authors.lastname: Prescott
authors.forename: Jacob
authors.initials: J
authors.lastname: Tfelt-Hansen
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D016757:Death, Sudden, Cardiac / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology / Q000517:prevention & control; D003718:Denmark / Q000453:epidemiology; D006331:Heart Diseases / Q000175:diagnosis*; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening; D013177:Sports; D013178:Sports Medicine; D014481:United States / Q000453:epidemiology; D055815:Young Adult