Sudden CV-related death not more common among college athletes

Maron BJ. J Am Coll Cardiol. 2014;doi:10.1016/j.jacc.2014.01.041.

  • March 26, 2014

College athletes in the United States are no more prone to sudden, CV-related death than the general population, although risk is higher among black and male athletes, according to recent study data.

Researchers evaluated data collected from the US National Sudden Death in Athletes Registry and the NCAA between 2002 and 2011 on deaths among intercollegiate athletes participating in organized sports. Cause of death was determined and autopsy reports were collected when available, and demographic and clinical data were obtained.

Within the evaluated period, 182 incidences of sudden death (85% male, 64% white) occurred among 4,052,369 participants in 30 intercollegiate sports. Age at death ranged from 17 to 26 years.

Of the observed deaths, 64 were considered probably or likely due to CV-related issues, and 47 cases were confirmed via postmortem diagnosis. The most common CV-related causes of death included hypertrophic cardiomyopathy (n=21), myocyte disarray (n=10) and congenital coronary anomalies (n=8). Common non–CV-related causes of death included suicide (n=31) and drug abuse (n=21).

Death related to confirmed CVD occurred at a rate of 1.2 deaths per 100,000 athlete-participation-years, or approximately four deaths per year. This result was similar to that observed for suicide and drug abuse in combination (1.3 deaths per 100,000 participation years, or 5 deaths/year; P=.39 for difference). When presumed CV-related death was included in analysis, CV-related mortality was more common than death due to suicide or drug abuse (1.5 deaths per 100,000 participation years; P<.0006).

Overall, athletes had lower CV-related mortality rates than the general population of a similar age, both for confirmed diagnoses (P<.0001) and presumed and confirmed diagnoses (P<.0007). Rates of suicide also were significantly higher in the general population (P<.0001 vs. athletes), and suicide was less frequent among athletes than non-athlete college students (P<.0001).

CV-related death was more common among black athletes than white athletes (3.8 vs. 0.7 deaths per 100,000 participation years). This number did not differ significantly from that observed in the general population at the same age and race (P=.6). Male athletes also died due to CV-related issues (1.8 vs. 0.3 per 100,000 participation years; P<.0001), suicide (1.1 vs. 0.3 per 100,000 participation years; P<.01) and drug abuse (0.9 vs. 0 per 100,000 participation years; P<.0001) more frequently than female athletes, but the mortality rates among males were similar to that observed in the similarly aged general male population (P=.7).

“NCAA student-athletes do not appear to be at unique or particularly high risk for [sudden death] due to unsuspected CVD,” the researchers concluded. “Furthermore, the relative importance of suicide and drug deaths reported here with respect to the health and safety of college athletes suggests there may be a disproportionate focus on CVD in this population.”

Disclosure: The researchers report no relevant financial disclosures.

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