American Heart Association supports findings by the University of Washington that sudden cardiac death is the leading cause of death of college athletes.
Sudden cardiac arrest of athletes in the United States is unknown, said researchers from the University of Washington in a new study, released in Circulation journal.
Estimates of the problem have been created from public media reports of tragic events in sports and the estimated participation rates of young athletes in sports. But, in this newly released study, researchers endeavored to put a more precise number on sudden cardiac death (SCD) in National Collegiate Athletic Association (NCAA) student-athletes, and determine the accuracy of current methods used for the collection of data involving SCD.
All cases of sudden death, i.e., not just cardiac, of NCAA student-athletes between Jan. 2004 and Dec. 2008 were identified by University of Washington researchers. The researchers used data identified by an NCAA data base; weekly systematic searches of public media reports; and catastrophic insurance claims.
Over this five-year period, 273 deaths and 1,969,663 athlete participant-years were determined. Of the identified 273 deaths, 187, or 68 percent, were due to nonmedical or traumatic causes; 80, or 29 percent, were due to medical causes; and six, or two percent, were due to unknown causes.
Cardiovascular-related sudden death was the leading cause reported in 45 (56%) of 80 of the medical cases, and represented 75 percent of sudden deaths during exertion.
Overall, the incidence of SCD was found to be 1:43,770 participants each year. Among NCAA Division I male basketball players, rate of SCD was 1:3100 each year.
Thirty nine of the 45 cases were identified only in the NCAA databases; 25 in public media reports; and nine in catastrophic claims data.
Also reported by the study:
- African-American athletes had a sudden cardiac death rate of one in 17,696, compared with one in 58,653 for Caucasian competitors.
- The risk for males was one in 33,134, compared with one in 76,646 for females.
- Basketball had the highest risk of sudden cardiac death, with a rate of one in 11,394. Swimming had the second-highest risk, followed by lacrosse, football and cross-country track.
“SCD is the leading medical cause of death and death during exercise in NCAA student-athletes,” concluded researchers. “Current methods of data collection underestimate the risk of SCD. Accurate assessment of SCD incidence is necessary to shape appropriate health policy decisions and develop effective strategies for prevention.”
However, the findings raise the question of how to deal with the number of deaths seen each year.
“You have to revisit the whole question of whether a more extensive screening makes sense in light of these new numbers,” said Kimberly Harmon, M.D., study author and clinical professor at the University of Washington. “The question is: where do you set the risk cutoff — one in 10,000, or 40,000, or 100,000?”
“The American Heart Association regards cardiovascular screening for athletes as an important public health issue, for which there are compelling ethical, legal and medical grounds,” said Ralph L. Sacco, M.S., M.D., president of the American Heart Association. “We strongly encourage student-athletes and other participants in organized competitive sports to be screened with a careful history, including family history, and thorough physical examination. The American Heart Association also believes healthcare professionals providing the screening should be able to order noninvasive testing when they judge it is needed.”
Harmon indicated that targeting the higher-risk groups, like basketball players, for more extensive screening may be practical, as would be placing automatic external defibrillators in sporting venues.
For more information, visit the American Heart Association online; the complete University of Washington study is also available online at Circulation journal.
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