title: Registry on acute cardiovascular events during endurance running races: the prospective RACE Paris registry.
abstract: Long distance running races are associated with a low risk of life-threatening events much often attributed to hypertrophic cardiomyopathy. However, retrospective analyses of aetiology lack consistency.
  
  
  
  Incidence and aetiology of life-threatening/fatal events were assessed in long distance races in the prospective Registre des Accidents Cardiaques lors des courses d'Endurance (RACE Paris Registry) from October 2006 to September 2012. Characteristics of life-threatening/fatal events were analysed by interviewing survivors and reviewing medical records including post-mortem data of each case. Seventeen life-threatening events were identified of 511 880 runners of which two were fatal. The vast majority were cardiovascular events (13/17) occurring in experienced male runners [mean (±SD) age 43 ± 10 years], with infrequent cardiovascular risk factors, atypical warning symptoms prior to the race or negative treadmill test when performed. Acute myocardial ischaemia was the predominant aetiology (8 of 13) and led to immediate myocardial revascularization. All cases with initial shockable rhythm survived. There was no difference in event rate according to marathons vs. half-marathons and events were clustered at the end of the race. A meta-analysis of all available studies including the RACE Paris registry (n = 6) demonstrated a low prevalence of life-threatening events (0.75/100 000) and that presentation with non-shockable rhythm [OR = 29.9; 95% CI (4.0-222.5), P = 0.001] or non-ischaemic aetiology [OR = 6.4; 95% CI (1.4-28.8), P = 0.015] were associated with case-fatality.
  
  
  
  Life-threatening/fatal events during long distance races are rare, most often unpredictable and mainly due to acute myocardial ischaemia. Presentation with non-shockable rhythm and non-ischaemic aetiology are the major determinant of case fatality.
authors.affiliation: Centre Chirurgical Marie Lannelongue, 133, avenue de la résistance, 92350 Le Plessis Robinson, Paris, France.
authors.forename: Benoît
authors.initials: B
authors.lastname: Gerardin
authors.affiliation: Univ Paris 06 (UPMC), ACTION Study Group, INSERM UMR_S 1166, Institut de Cardiologie, PitiéSalpêtrière Hospital (AP-HP, Paris, France jean-philppe.collet@psl.aphp.fr.
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Collet
authors.affiliation: Hôpital Universitaire de Genève, rue Gabrielle Perret-Gentil, 1211 Genève 14, Switzerland.
authors.forename: Hazrije
authors.initials: H
authors.lastname: Mustafic
authors.affiliation: Centre hospitalier La Fontonne, 107 avenue de Nice, 06600 Antibes, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Bellemain-Appaix
authors.affiliation: Hôpital Foch, 40 rue Worth, 92151 Suresnes, France.
authors.forename: Hakim
authors.initials: H
authors.lastname: Benamer
authors.affiliation: Groupe Hospitalier Mutualiste de Grenoble, 8, rue du Dr Calmette, 38000 Grenoble, France.
authors.forename: Jacques
authors.initials: J
authors.lastname: Monsegu
authors.affiliation: Centre hospitalo-universitaire Henri Mondor, 51 av du maréchal de Lattre de Tassigny, 94000 Créteil, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Teiger
authors.affiliation: Hôpital André Mignot, 177, rue de Versailles, 78150 Le Chesnay, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Livarek
authors.affiliation: SAMU 75: Hôpital Necker, 149 rue de Sèvres, 75015 Paris, France.
authors.forename: Murielle
authors.initials: M
authors.lastname: Jaffry
authors.affiliation: SAMU 75: Hôpital Necker, 149 rue de Sèvres, 75015 Paris, France.
authors.forename: Lionel
authors.initials: L
authors.lastname: Lamhaut
authors.affiliation: SAMU 92: Hôpital de Garches, 104 boulevard Raymond Poincaré, 92380 Garches, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Fleischel
authors.affiliation: Centre hospitalo-universitaire Bichat - Claude Bernard, 46 rue Huchard, 75018 Paris, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Aubry
mesh_terms: D000328:Adult; D016757:Death, Sudden, Cardiac; D006801:Humans; D008297:Male; D010297:Paris; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D012420:Running
keywords: Acute coronary syndrome; Marathons; Sport cardiology; Sudden death