title: Demographics and Epidemiology of Sudden Deaths in Young Competitive Athletes: From the United States National Registry.
abstract: BACKGROUND
  Sudden deaths in young competitive athletes are tragic events, with high public visibility. The importance of race and gender with respect to sport and the diagnosis and causes of sudden death in athletes has generated substantial interest.
  
  
  METHODS
  The US National Registry of Sudden Death in Athletes, 1980-2011, was accessed to define the epidemiology and causes of sudden deaths in competitive athletes. A total of 2406 deaths were identified in young athletes aged 19 ± 6 years engaged in 29 diverse sports.
  
  
  RESULTS
  Among the 842 athletes with autopsy-confirmed cardiovascular diagnoses, the incidence in males exceeded that in females by 6.5-fold (1:121; 691 vs 1:787,392 athlete-years; P ≤.001). Hypertrophic cardiomyopathy was the single most common cause of sudden death, occurring in 302 of 842 athletes (36%) and accounting for 39% of male sudden deaths, almost 4-fold more common than among females (11%; P ≤.001). More frequent among females were congenital coronary artery anomalies (33% vs 17% of males; P ≤.001), arrhythmogenic right ventricular cardiomyopathy (13% vs 4%; P = .002), and clinically diagnosed long QT syndrome (7% vs 1.5%; P ≤.002). The cardiovascular death rate among African Americans/other minorities exceeded whites by almost 5-fold (1:12,778 vs 1:60; 746 athlete-years; P <.001), and hypertrophic cardiomyopathy was more common among African Americans/other minorities (42%) than in whites (31%; P ≤.001). Male and female basketball players were 3-fold more likely to be African American/other minorities than white.
  
  
  CONCLUSIONS
  Within this large forensic registry of competitive athletes, cardiovascular sudden deaths due to genetic and/or congenital heart diseases were uncommon in females and more common in African Americans/other minorities than in whites. Hypertrophic cardiomyopathy is an under-appreciated cause of sudden death in male minority athletes.
authors.affiliation: Hypertrophic Cardiomyopathy Center, Minneapolis Heart Institute Foundation, Minn. Electronic address: hcm.maron@mhif.org.
authors.forename: Barry J
authors.initials: BJ
authors.lastname: Maron
authors.affiliation: Hypertrophic Cardiomyopathy Center, Minneapolis Heart Institute Foundation, Minn.
authors.forename: Tammy S
authors.initials: TS
authors.lastname: Haas
authors.affiliation: Hypertrophic Cardiomyopathy Center, Minneapolis Heart Institute Foundation, Minn.
authors.forename: Aneesha
authors.initials: A
authors.lastname: Ahluwalia
authors.affiliation: Hypertrophic Cardiomyopathy Center, Minneapolis Heart Institute Foundation, Minn.
authors.forename: Caleb J
authors.initials: CJ
authors.lastname: Murphy
authors.affiliation: Hypertrophic Cardiomyopathy Center, Minneapolis Heart Institute Foundation, Minn.
authors.forename: Ross F
authors.initials: RF
authors.lastname: Garberich
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D019571:Arrhythmogenic Right Ventricular Dysplasia / Q000150:complications / Q000453:epidemiology*; D056352:Athletes / Q000706:statistics & numerical data*; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications / Q000453:epidemiology*; D002423:Cause of Death; D003324:Coronary Artery Disease / Q000150:complications / Q000453:epidemiology; D003330:Coronary Vessel Anomalies / Q000150:complications / Q000453:epidemiology*; D016757:Death, Sudden, Cardiac / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D015994:Incidence; D008133:Long QT Syndrome / Q000150:complications / Q000453:epidemiology; D008297:Male; D008945:Mitral Valve Prolapse / Q000150:complications / Q000453:epidemiology; D009205:Myocarditis; D012042:Registries; D017678:Sex Distribution; D013177:Sports / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data; D014927:Wolff-Parkinson-White Syndrome / Q000150:complications / Q000453:epidemiology; D055815:Young Adult
keywords: Athletes; Congenital heart disease; Hypertrophic cardiomyopathy; Sudden death