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. 2023 Mar 21;81(11):1021-1031.
doi: 10.1016/j.jacc.2023.01.015.

Incidence of Cardiac Arrest During Sports Among Women in the European Union

Orianne Weizman  1 , Jean-Philippe Empana  1 , Marieke Blom  2 , Hanno L Tan  2 , Martin Jonsson  3 , Kumar Narayanan  1 , Mattias Ringh  3 , Eloi Marijon  4 , Xavier Jouven  5 ; ESCAPE-NET Investigators
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Free article

Incidence of Cardiac Arrest During Sports Among Women in the European Union

Orianne Weizman et al. J Am Coll Cardiol. .
Free article

Abstract

Background: Women represent a growing proportion of sports participants. Still, few original data regarding sudden cardiac arrest during sports (Sr-SCA) in women are available.

Objectives: The authors sought to assess the incidence, characteristics, and outcomes of women presenting with Sr-SCA.

Methods: Data were analyzed from 3 population-based European registries (ESCAPE-NET 2020 Horizon Program) that prospectively and exhaustively collect every case of SCA: SDEC (Paris-Sudden Death Expertise Center), ARREST (AmsteRdam REsuscitation Studies), and SRCR (Swedish Register for Cardiopulmonary Resuscitation). Sr-SCA was defined as SCA during or ≤1 hour after cessation of sports activity.

Results: Of 34,826 SCA between 2006 and 2017, 760 Sr-SCA (2.2%) were identified, including 54 in women. The average annual incidence of Sr-SCA in women in the 3 registries ranged from 0.10 per million (95% CI: 0.01-0.71 per million) to 0.38 per million (95% CI: 0.14-1.04 per million). Overall, the average annual incidence rate of Sr-SCA in women was 0.19 per million (95% CI: 0.14-0.24 per million), >10-fold lower compared with men (2.63 per million [95% CI: 2.45-2.83 per million]; P < 0.0001). When extrapolating to the total European population and accounting for age and sex, this yields 98 cases per year (95% CI: 72-123 cases per year) in women and 1,350 cases per year (95% CI: 1,256-1,451 cases per year) in men. Subject characteristics and circumstances of occurrence were similar in women vs men. Bystander response, time to defibrillation, and survival rate at hospital admission (58.8% vs 58.5%; P = 0.99) and 30 days did not differ significantly between women and men.

Conclusions: These findings emphasize the dramatically lower risk of Sr-SCA in women compared with men, despite similar subject characteristics. This should be considered in designing preparticipation screening strategies in the future.

Keywords: Europe; sex; sports; sudden cardiac death; women.

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Conflict of interest statement

Funding Support and Author Disclosures This work was funded by Horizon 2020, grant agreement No. 733381, and COST Action PARQ (grant agreement No CA19137) supported by COST (European Cooperation in Science and Technology). The Paris-SDEC activities are also supported by the Institut National de la Santé et de la Recherche Médicale (INSERM), University of Paris, Assistance Publique-Hôpitaux de Paris, Fondation Coeur et Artères, Global Heart Watch, Fédération Française de Cardiologie, Société Française de Cardiologie, Fondation Recherche Medicale, as well as unrestricted grants from industrial partners (Abbott, Biotronik, Boston Scientific, Medtronic, MicroPort, Schiller and Zoll). The authors have reported that they have no relationships relevant to the contents of this paper to disclose.

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