title: Sports-related sudden cardiac deaths in the young population of Switzerland.
abstract: BACKGROUND
  In Switzerland, ECG screening was first recommended for national squad athletes in 1998. Since 2001 it has become mandatory in selected high-risk professional sports. Its impact on the rates of sports-related sudden cardiac death (SCD) is unknown.
  
  
  OBJECTIVE
  We aimed to study the incidence, causes and time trends of sports-related SCD in comparison to SCD unrelated to exercise in Switzerland.
  
  
  METHODS
  We reviewed all forensic reports of SCDs of the German-speaking region of Switzerland in the age group of 10 to 39 years, occurring between 1999 and 2010. Cases were classified into three categories based on whether or not deaths were associated with sports: no sports (NONE), recreational sports (REC), and competitive sports (COMP).
  
  
  RESULTS
  Over the 12-year study period, 349 SCD cases were recorded (mean age 30±7 years, 76.5% male); 297 cases were categorized as NONE, 31 as REC, and 21 as COMP. Incidences of SCD per 100,000 person-years [mean (95% CI)] were the lowest in REC [0.43 (0.35-0.56)], followed by COMP [1.19 (0.89-1.60)] and NONE [2.46 (2.27-2.66)]. In all three categories, coronary artery disease (CAD) with or without acute myocardial infarction (MI) was the most common cause of SCD. Three professional athletes were identified in COMP category which all had SCD due to acute MI. There were no time trends, neither in overall, nor in cause-specific incidences of SCD.
  
  
  CONCLUSIONS
  The incidence of SCD in young individuals in Switzerland is low, both related and unrelated to sports. In regions, like Switzerland, where CAD is the leading cause of SCD associated with competitions, screening for cardiovascular risk factors in addition to the current PPS recommendations might be indicated to improve detection of silent CAD and further decrease the incidence of SCD.
authors.affiliation: University Clinic for Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
authors.forename: Babken
authors.identifier: http://orcid.org/0000-0002-0050-5717
authors.initials: B
authors.lastname: Asatryan
authors.affiliation: University Clinic for Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
authors.forename: Cristina
authors.initials: C
authors.lastname: Vital
authors.affiliation: University Clinic for Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
authors.forename: Christoph
authors.initials: C
authors.lastname: Kellerhals
authors.affiliation: University Clinic for Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
authors.forename: Argelia
authors.initials: A
authors.lastname: Medeiros-Domingo
authors.affiliation: University Heart Center, Zurich, Switzerland.
authors.forename: Christoph
authors.initials: C
authors.lastname: Gräni
authors.affiliation: University Clinic for Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
authors.forename: Lukas D
authors.initials: LD
authors.lastname: Trachsel
authors.affiliation: University Heart Center, Zurich, Switzerland.
authors.forename: Christian M
authors.initials: CM
authors.lastname: Schmied
authors.affiliation: University Heart Center, Zurich, Switzerland.
authors.forename: Ardan M
authors.initials: AM
authors.lastname: Saguner
authors.affiliation: University Clinic for Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
authors.forename: Prisca
authors.initials: P
authors.lastname: Eser
authors.affiliation: University Clinic for Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
authors.forename: David
authors.initials: D
authors.lastname: Herzig
authors.affiliation: Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland.
authors.forename: Stephan
authors.initials: S
authors.lastname: Bolliger
authors.affiliation: Unit of Forensic Medicine, University Center for Legal Medicine, Lausanne, Switzerland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Michaud
authors.affiliation: University Clinic for Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
authors.forename: Matthias
authors.initials: M
authors.lastname: Wilhelm
mesh_terms: D000293:Adolescent; D000328:Adult; D056352:Athletes; D002648:Child; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000453:epidemiology; D016757:Death, Sudden, Cardiac / Q000453:epidemiology / Q000517:prevention & control*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening / Q000379:methods*; D009203:Myocardial Infarction / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D013177:Sports; D013557:Switzerland / Q000453:epidemiology; D055815:Young Adult