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Abstract
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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 AND RESULTS: U.S. 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 2,406 deaths were identified in young athletes aged 19 ± 6 years engaged in 29 diverse sports. Among the 842 athletes with autopsy-confirmed cardiovascular diagnoses, incidence in males exceeded females 6.5-fold (1:121, 691 vs. 1:787,392 athlete-years (p=<0.001). Hypertrophic cardiomyopathy was the single most common cause of sudden death, occurring in 302/842 athletes (36%), and accounting for 39% of male sudden deaths, almost 4-fold more common than among females (11%; p=<0.001). More frequent among females were congenital coronary artery anomalies (33% vs. 17% of males; p=<0.001), arrhythmogenic right ventricular cardiomyopathy (13% vs. 4%; p= 0.002), and clinically diagnosed long-QT syndrome (7% vs. 1.5%; p= <0.002). Cardiovascular death rate among African-Americans/other minorities exceeded whites almost 5-fold (1:12,778 vs 1:60;746 athlete-years; p <0.001) and hypertrophic cardiomyopathy was more common among African-Americans/other minorities (42%) than in whites (31%; p=<0.001). Male and female basketball players were 3X more likely to be African-American/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-American/minorities than in whites. Hypertrophic cardiomyopathy is an under-appreciated cause of sudden death in male minority athletes.
Copyright © 2016 Elsevier Inc. All rights reserved.
Language: en |