Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2022 May 1;57(5):431-443.
doi: 10.4085/1062-6050-0748.20.

Incidence of Sudden Cardiac Arrest and Death in Young Athletes and Military Members: A Systematic Review and Meta-Analysis

Aaron Lear  1 , Niraj Patel  2 , Chanda Mullen  1 , Marian Simonson  3 , Vince Leone  1   4 , Constantinos Koshiaris  5 , David Nunan  5
Affiliations
Meta-Analysis

Incidence of Sudden Cardiac Arrest and Death in Young Athletes and Military Members: A Systematic Review and Meta-Analysis

Aaron Lear et al. J Athl Train. .

Abstract

Objective: To evaluate the quality of the evidence on the incidence of sudden cardiac arrest (SCA) and sudden cardiac death (SCD) in athletes and military members and estimate the annual incidence of SCA and SCD.

Data sources: We searched MEDLINE, Embase, Cochrane CENTRAL, Web of Science, BIOSIS, Scopus, SPORTDiscus, PEDro, and ClinicalTrials.gov from inception to dates between February 21 and July 29, 2019.

Study selection: Studies in which the incidence of SCA, SCD, or both in athletes or military members aged <40 years was reported were eligible for inclusion. We identified 40 studies for inclusion.

Data extraction: Risk of bias (ROB) was assessed using a validated, customized tool for prevalence studies. Twelve had a low ROB, while the remaining 28 had a moderate or high ROB. Data were extracted for narrative review and meta-analysis.

Data synthesis: Random-effects meta-analysis was performed in studies judged to have a low ROB in 2 categories: (1) 5 studies of regional- or national-level data, including athletes at all levels and both sexes, demonstrated 130 SCD events with a total of 11 272 560 athlete-years, showing a cumulative incidence rate of 0.98 (95% CI = 0.62, 1.53) per 100 000 athlete-years and high heterogeneity (I2 = 78%) and (2) 3 studies of competitive athletes aged 14 to 25 years were combined for a total of 183 events and 17 798 758 athlete-years, showing an incidence rate of 1.91 (95% CI = 0.71, 5.14) per 100 000 athlete-years and high heterogeneity (I2 = 97%). The remaining low-ROB studies involved military members and were not synthesized.

Conclusions: The worldwide incidence of SCD is rare. Low-ROB studies indicated the incidence was <2 per 100 000 athlete-years. Overall, the quality of the available evidence was low, but high-quality individual studies inform the question of incidence levels.

Prospero registration: CRD42019125560.

Keywords: cardiology; exercise; sport; sudden death.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram.
Figure 2
Figure 2
Incidence rates of sudden cardiac death reported by included studies.
Figure 3
Figure 3
Incidence rates of sudden cardiac arrest reported by included studies.
Figure 4
Figure 4
Meta-analyses of the incidence rate of sudden cardiac death in low risk-of-bias studies, A, at population levels and, B, in competitive athletes between the ages of 14 and 25 years.
See this image and copyright information in PMC

References

    1. Harmon KG, Asif IM, Maleszewski JJ, et al. Incidence, cause, and comparative frequency of sudden cardiac death in National Collegiate Athletic Association athletes: a decade in review. Circulation . 2015;132(1):10–19. doi: 10.1161/CIRCULATIONAHA.115.015431. - DOI - PMC - PubMed
    1. Drezner JA, O'Connor FG, Harmon KG, et al. AMSSM position statement on cardiovascular preparticipation screening in athletes: current evidence, knowledge gaps, recommendations and future directions. Br J Sports Med . 2017;51(3):153–167. 10.1136/bjsports-2016-096781 Published correction appears in Br J Sports Med 2018;52(9):599. doi: 10.1136/bjsports-2016-096781corr1. - DOI - DOI - PubMed
    1. Van Brabandt H, Desomer A, Gerkens S, Neyt M. Harms and benefits of screening young people to prevent sudden cardiac death. BMJ . 2016;353(i1156) doi: 10.1136/bmj.i1156. - DOI - PubMed
    1. Drezner JA, Harmon KG, Asif IM, Marek JC. Why cardiovascular screening in young athletes can save lives: a critical review. Br J Sports Med . 2016;50(22):1376–1378. doi: 10.1136/bjsports-2016-096606. - DOI - PubMed
    1. Harmon KG, Drezner JA, Wilson MG, Sharma S. Incidence of sudden cardiac death in athletes: a state-of-the-art review. Br J Sports Med . 2014;48(15):1185–1192. doi: 10.1136/bjsports-2014-093872. - DOI - PubMed

LinkOut - more resources