Incidence and etiology of sports-related sudden cardiac death in Denmark--implications for preparticipation screening.
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.
Holst
Anders Gaarsdal
AG
Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC), University of Copenhagen, Denmark. anders@kanten.dk
Winkel
Bo Gregers
BG
Theilade
Juliane
J
Kristensen
Ingrid Bayer
IB
Thomsen
Jørgen Lange
JL
Ottesen
Gyda Lolk
GL
Svendsen
Jesper Hastrup
JH
Haunsø
Stig
S
Prescott
Eva
E
Tfelt-Hansen
Jacob
J
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