Abstract 16040: Cardiac Arrest in Sports versus Sedentary Settings in Young Patients
Introduction: Sudden cardiac arrest (SCA) in the young athlete is a devastating condition and drives current strategies for screening and prevention in this age group. A community-wide comparison of SCA in the presence versus absence of sporting activity has not been performed
Methods: We prospectively evaluated the burden and outcomes of SCA age 5-35 years in the Portland, OR metropolitan area ( 2002-2015). We compared the circumstances, clinical profile and resuscitation outcomes of subjects that suffered SCA in the presence or absence of sports activity, by a detailed evaluation of emergency response records, lifetime clinical records and autopsy examination.
Results: Out of 3775 cardiac arrests in all age groups, 186 (5%) occurred in the young. Of the latter, 26 (14%) were associated with sports (Mean age 20.5±6.7, 81% male) and the remainder (n=160) occurred in a sedentary setting (age 26.7±6.5; p<0.01, 65% male; p 0.11). Identified conditions associated with sports-SCA were hypertrophic cardiomyopathy (HCM, 33%), coronary artery disease (CAD, 14%), congenital heart disease (ConHD,10%), acute myocarditis (5%), arrhythmogenic right ventricular dysplasia (5%) and unexplained (29%). In sedentary-SCA cases CAD was most common (23%), followed by cardiomyopathy/heart failure/valve disease (17%), HCM (12%), isolated left ventricular hypertrophy (8%), coronary anomalies (4%), long QT syndrome (3%), ConHD (3%), acute myocarditis (1%), and unexplained (30%). Sedentary SCA cases were more likely to be obese (BMI 32±13 vs. 23±5; p <0.01), diabetic (10% vs. 0; p 0.13), hypertensive (16% vs. 4%; p=0.21 ) and smokers (26% vs. 8%). Comparisons of established cardiovascular risk factors (obesity, hypertension, hyperlipidemia, smoking) showed that sedentary-SCA cases were significantly more likely to have ≥1 risk factor (63% vs. 29%, p=0.003). However, survival outcomes were 3-fold higher in sports-SCA vs. sedentary-SCA (31% vs. 11%; p 0.03).
Conclusions: Standard cardiovascular risk factors may play a larger role in young SCA than previously anticipated, especially sedentary SCA cases. These findings highlight the need for public health approaches that screen and prevent at earlier ages, in order to reduce the burden of SCA in the young.
- Cardiac arrest
- Cardiovascular disease
- Patient education/teaching psychosocial aspects
- Hypertrophic cardiomyopathy
Author Disclosures: R. Jayaraman: None. S. Nair: None. K. Reinier: None. A. Evanado: None. C. Teodorescu: None. H. Chugh: None. K. Gunsen: None. J. Jui: None. S.S. Chugh: Research Grant; Significant; NIH (NHLBI), R01HL126938 and R01HL122492.
- © 2016 by American Heart Association, Inc.