TOPLINE:
The overall survival after sudden cardiac arrest (SCA), including those resulting from exertional events, improved over a 9-year period among young competitive athletes in the United States. However, racial disparities were identified with reduced survival among Black athletes.
METHODOLOGY:
- SCA is the primary medical cause of death in young competitive athletes.
- Researchers conducted an observational study in the United States to assess the survival outcomes and trends following SCA among young competitive athletes.
- They included athletes aged 11 years or older participating in middle or high school, club, college, or semiprofessional or professional sports or former athletes who had participated in competitive sports within the past year (n = 641) who experienced SCA (n = 315; mean age, 16 years; 86% male athletes) or sudden cardiac death (n = 326; mean age, 17 years; 85% male athletes) between 2014 and 2023.
- SCA was defined as an unexpected and abrupt collapse requiring cardiopulmonary resuscitation (CPR) or defibrillation where the individual survived, and sudden cardiac death referred to an unexpected and abrupt death from a cardiac cause.
- Exertional events included SCA or sudden cardiac deaths occurring during exercise, while nonexertional events included those occurring within 1 hour of exercise, at rest, or during sleep.
TAKEAWAY:
- Overall, 75% SCA or sudden cardiac death events occurred during exertion, 3% occurred within 1 hour of exertion, and 16% occurred during relative rest or sleep; the cause was unknown in 5% cases.
- The overall survival rate was 49%, ranging from 30% to 66%, per academic year, with a significant increase observed over the 9-year period (P = .007).
- The overall survival rate from exertional SCA was 57% per academic year and increased over 9 years (P = .03), with higher survival among athletes who experienced the arrest during a game or competition vs during practice or training (70% vs 53%; P = .001).
- Factors independently associated with a relatively reduced survival from SCA included Black race (P < .0001), other races including Hispanic or Latino, Asian, and others (P = .02), and nonexertional SCA (P < .0001).
IN PRACTICE:
“Although these data may be encouraging, further education, research, and policy changes are needed to improve outcomes following SCA among young athletes. Specifically universal emergency preparedness to sports-related SCA, especially in the practice setting, is needed and should include broader education on the recognition of SCA in athletes, CPR training for potential rescuers, and access to AEDs [automated external defibrillators],” the authors wrote.
SOURCE:
This study was led by Bradley J. Petek, MD, from the Oregon Health and Science University in Portland, Oregon. It was published online on March 30, 2025, in Journal of the American College of Cardiology.
LIMITATIONS:
The total number of cases may have been underestimated due to the lack of mandatory reporting for sudden cardiac events among young athletes in the United States. Compared with exertional events, nonexertional events may have been underreported. Additionally, the athletes might have identified with a different race than that reported in the study.
DISCLOSURES:
This study was supported, in part, by the National Center for Catastrophic Sports Injury Research at the University of North Carolina at Chapel Hill. Several authors reported receiving funding from sources such as the National Institutes of Health, National Heart, Lung, and Blood Institute, American Heart Association, and the American Medical Society for Sports Medicine.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.