Sudden Cardiac Death Higher Among Black College Athletes

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New research indicates that sudden cardiac death among college athletes is more common than previously believed, and is in fact the leading medical cause of death among this population. The risk of dying from a sudden cardiac event was found to be more than three times higher among black college athletes.

Should college athletes be screened?

The rate of sudden cardiac death among college athletes has mainly been based on information provided by the media and from insurance company claims. Now, a new study conducted by Kimberly Harmon, MD of the University of Washington in Seattle, and her colleagues, provide new figures based on data from different sources.

The data was collected from the National Collegiate Athletic Association’s (NCAA) database on student athletes who died and from Parent Heart Watch, a nonprofit that searches the media for reports of sudden cardiac death and cardiac arrest in young people. Data was gathered from 2004 through 2008.

The study period covered nearly 2 million athlete participant years and uncovered 273 deaths from any cause. Twenty-nine percent of the deaths were due to medical causes, and of these, 45 (56%) were from sudden cardiac death.

The data indicated some clear differences between sex, race, and type of sport concerning the deaths. Blacks, for example, showed a greater than threefold risk of dying than did whites: one out of every 17,696 compared with one out of every 58,653 per year, respectively.

Female athletes fared better than males, who were more than twice as likely to die suddenly. The sport having the greatest risk of sudden death was basketball. In fact, the college athletes at greatest risk of sudden death are Division I male basketball players, where one out of every 3,126 die of this cause.

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According to recent data released by the NCAA, 60.9 percent of Division I basketball players are black, compared with 30.5 percent who are white.

Basketball was seconded by swimming. Lacrosse, football, and cross-country rounded out the top five riskiest sports for college players.

One way to help safeguard against sudden cardiac death and other cardiac events in college athletes would be to have athletes undergo electrocardiographic (ECG) screening before they participate in their chosen sport. Professional organizations, however, have not agreed on the cost-effectiveness of such routine screenings.

Harmon and her team noted that their findings could impact decisions to use ECG screening of college athletes. They argued that “a history and physical examination without an ECG [the current recommendation of the American Heart Association] are of questionable value and have been shown not to be cost-effective because of their poor sensitivity and specificity.”

Currently, the European Society of Cardiology and the International Olympic Committee recommend athletes undergo an ECG as part of routine screening before they participate in sports.

Based on the new findings, the researchers said routine ECG screening be considered, at least in high-risk groups, and that automated external defibrillators be available where sports with the highest risks of sudden cardiac death are played, such as NCAA basketball games. Preparing for sudden cardiac arrest among cross-country runners is more problematic.

SOURCES:
Harmon K et al. Circulation 2011; 123(15): 1594-1600
National Collegiate Athletic Association

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