title: Sudden cardiac arrest during sports activity in middle age.
abstract: BACKGROUND
  Sports-associated sudden cardiac arrests (SCAs) occur mostly during middle age. We sought to determine the burden, characteristics, and outcomes of SCA during sports among middle-aged residents of a large US community.
  
  
  RESULTS
  Patients with SCA who were 35 to 65 years of age were identified in a large, prospective, population-based study (2002-2013), with systematic and comprehensive assessment of their lifetime medical history. Of the 1247 SCA cases, 63 (5%) occurred during sports activities at a mean age of 51.1±8.8 years, yielding an incidence of 21.7 (95% confidence interval, 8.1-35.4) per 1 million per year. The incidence varied significantly by sex, with a higher incidence among men (relative risk, 18.68; 95% confidence interval, 2.50-139.56) for sports SCAs compared with all other SCAs (relative risk 2.58; 95% confidence interval, 2.12-3.13). Sports SCA was also more likely to be a witnessed event (87% versus 53%; P<0.001) with cardiopulmonary resuscitation (44% versus 25%; P=0.001) and ventricular fibrillation (84% versus 51%; P<0.0001). Survival to hospital discharge was higher for sports-associated SCA (23.2% versus 13.6%; P=0.04). Sports SCA cases presented with known preexisting cardiac disease in 16% and ≥1 cardiovascular risk factors in 56%, and overall, 36% of cases had typical cardiovascular symptoms during the week preceding the SCA.
  
  
  CONCLUSIONS
  Sports-associated SCA in middle age represents a relatively small proportion of the overall SCA burden, reinforcing the idea of the high-benefit, low-risk nature of sports activity. Especially in light of current population aging trends, our findings emphasize that targeted education could maximize both safety and acceptance of sports activity in the older athlete.
authors.affiliation: From The Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA (E.M., A.U.-E., K.R., C.T., K.N., S.S.C.); European Georges Pompidou Hospital, Cardiology Department, and Paris Descartes University, Paris, France (E.M., X.J.); Oregon Health & Science University, Portland, OR (K.G., J.J.).
authors.forename: Eloi
authors.initials: E
authors.lastname: Marijon
authors.affiliation: From The Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA (E.M., A.U.-E., K.R., C.T., K.N., S.S.C.); European Georges Pompidou Hospital, Cardiology Department, and Paris Descartes University, Paris, France (E.M., X.J.); Oregon Health & Science University, Portland, OR (K.G., J.J.).
authors.forename: Audrey
authors.initials: A
authors.lastname: Uy-Evanado
authors.affiliation: From The Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA (E.M., A.U.-E., K.R., C.T., K.N., S.S.C.); European Georges Pompidou Hospital, Cardiology Department, and Paris Descartes University, Paris, France (E.M., X.J.); Oregon Health & Science University, Portland, OR (K.G., J.J.).
authors.forename: Kyndaron
authors.initials: K
authors.lastname: Reinier
authors.affiliation: From The Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA (E.M., A.U.-E., K.R., C.T., K.N., S.S.C.); European Georges Pompidou Hospital, Cardiology Department, and Paris Descartes University, Paris, France (E.M., X.J.); Oregon Health & Science University, Portland, OR (K.G., J.J.).
authors.forename: Carmen
authors.initials: C
authors.lastname: Teodorescu
authors.affiliation: From The Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA (E.M., A.U.-E., K.R., C.T., K.N., S.S.C.); European Georges Pompidou Hospital, Cardiology Department, and Paris Descartes University, Paris, France (E.M., X.J.); Oregon Health & Science University, Portland, OR (K.G., J.J.).
authors.forename: Kumar
authors.initials: K
authors.lastname: Narayanan
authors.affiliation: From The Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA (E.M., A.U.-E., K.R., C.T., K.N., S.S.C.); European Georges Pompidou Hospital, Cardiology Department, and Paris Descartes University, Paris, France (E.M., X.J.); Oregon Health & Science University, Portland, OR (K.G., J.J.).
authors.forename: Xavier
authors.initials: X
authors.lastname: Jouven
authors.affiliation: From The Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA (E.M., A.U.-E., K.R., C.T., K.N., S.S.C.); European Georges Pompidou Hospital, Cardiology Department, and Paris Descartes University, Paris, France (E.M., X.J.); Oregon Health & Science University, Portland, OR (K.G., J.J.).
authors.forename: Karen
authors.initials: K
authors.lastname: Gunson
authors.affiliation: From The Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA (E.M., A.U.-E., K.R., C.T., K.N., S.S.C.); European Georges Pompidou Hospital, Cardiology Department, and Paris Descartes University, Paris, France (E.M., X.J.); Oregon Health & Science University, Portland, OR (K.G., J.J.).
authors.forename: Jonathan
authors.initials: J
authors.lastname: Jui
authors.affiliation: From The Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA (E.M., A.U.-E., K.R., C.T., K.N., S.S.C.); European Georges Pompidou Hospital, Cardiology Department, and Paris Descartes University, Paris, France (E.M., X.J.); Oregon Health & Science University, Portland, OR (K.G., J.J.). sumeet.chugh@cshs.org.
authors.forename: Sumeet S
authors.initials: SS
authors.lastname: Chugh
mesh_terms: D000328:Adult; D000367:Age Factors; D002311:Cardiomyopathy, Dilated / Q000150:complications; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications; D016887:Cardiopulmonary Resuscitation / Q000706:statistics & numerical data; D015897:Comorbidity; D003327:Coronary Disease / Q000150:complications; D016757:Death, Sudden, Cardiac / Q000453:epidemiology; D004632:Emergency Medical Services / Q000706:statistics & numerical data; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009922:Oregon / Q000453:epidemiology; D058687:Out-of-Hospital Cardiac Arrest / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D011446:Prospective Studies; D012306:Risk; D012621:Seasons; D012737:Sex Factors; D013177:Sports; D014505:Urban Population / Q000706:statistics & numerical data; D014693:Ventricular Fibrillation / Q000453:epidemiology / Q000628:therapy
keywords: death, sudden; exercise; heart arrest; ventricular fibrillation
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