Sports-Related Sudden Cardiac Death in a Competitive and a Noncompetitive Athlete Population Aged 12 to 49 Years: Data From an Unselected Nationwide Study in Denmark

Study Questions:

What is the incidence of sports-related sudden cardiac deaths (SrSCDs) in persons ages 12-49 years, and is there a difference in SrSCD incidence rate between competitive and noncompetitive athletes?


All deaths among persons ages 12-49 years from 2007-2009 in Denmark were included. Death certificates were reviewed. History of previous admissions to the hospital was assessed, and discharge summaries and autopsy reports were read. SCDs and SrSCD cases were identified.


In the 3-year period, there were 881 SCDs, among which 44 SrSCDs were identified. In noncompetitive athletes ages 12-35 years, the incidence rate of SrSCD was 0.43 (95% confidence interval [CI], 0.16-0.94) per 100,000 athlete person-years versus 2.95 (95% CI, 1.95-4.30) in noncompetitive athletes ages 36-49 years. In competitive athletes, the incidence rate of SrSCD was 0.47 (95% CI, 0.10-1.14) and 6.64 (95% CI, 2.86-13.1) per 100,000 athlete person-years in those ages 12-35 years and 36-49 years, respectively. The incidence rate of SCD in the general population was 10.7 (95% CI, 10.0-11.5) per 100,000 person-years.


The incidence rates of SrSCD in noncompetitive and competitive athletes are not different. The study showed an increase in the incidence rate of SrSCD in persons ages 36-49 years in both noncompetitive and competitive athletes compared to those ages 12-35 years. Importantly, SCD in the general population is much more prevalent than is SrSCD in all age groups.


This study offers additional insights into the complex debate on the appropriateness of competitive athlete pre-participation screening. Such screening has been recommended by some based on data mainly from Italy suggesting that competitive athletes are at highest risk of SCD. The current study calls this practice into question. At least in Denmark, SrSCD appears no more likely among competitive than noncompetitive athletes, and SCD risk is much higher in the general population.

Clinical Topics: Arrhythmias and Clinical EP, Heart Failure and Cardiomyopathies, Sports and Exercise Cardiology, SCD/Ventricular Arrhythmias

Keywords: Athletes, Cardiomyopathy, Hypertrophic, Denmark, Death Certificates, Sports, Autopsy, Death, Sudden, Cardiac

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