Acute cardiac care & resuscitationCohort study
Sudden Cardiac Death in National Collegiate Athletic Association Athletes: A 20-Year Study
- Retrospective cohort study
- 20-year time frame
- 4 independent databases and search strategies
- expert panel adjudication
Authors' conclusion
The incidence of SCD in college athletes has decreased. Male sex, Black race, and basketball are associated with a higher incidence of SCD.
Study context
- Population
- National Collegiate Athletic Association athletes, July 1, 2002, through June 30, 2022Sudden cardiac death (SCD) cases of 1102 deaths
- Participants
- 143 athletes
- Outcome
- Incidence, causes and trends of SCD
Main finding
As reported in the abstract
Overall incidence of SCD
Overall incidence of SCD
1:63 682 athlete-years (95% CI 1:54 065-1:75 010)
SCD incidence trend, 5-year IRR
0.71 (95% CI 0.61-0.82)
Observational data: associations, not effects.
Further findings
| Outcome | Values |
|---|---|
| SCD incidence by sex | Male 1:43 348 (95% CI 1:36 228-1:51 867) athlete-years · Female 1:164 504 (95% CI 1:110 552-1:244 787) athlete-years |
| SCD incidence by race | Black 1:26 704 (interval 1:20 417-1:34 925) athlete-years · White 1:74 581 (interval 1:60 247-1:92 326) athlete-years |
SCD incidence, Division I male basketball players
- Highest incidence: Division I male basketball
- 1:8188
- White
- 1:5848
- Black
- 1:7696 athlete-years
Noncardiovascular deaths trend
- Remained stable, 5-year IRR
- 0.98 (95% CI 0.94-1.04)
Postmortem findings (118 of 143 adjudicable)
- Autopsy-negative sudden unexplained death
- 19.5%
- Idiopathic LV hypertrophy or possible cardiomyopathy
- 16.9%
- Hypertrophic cardiomyopathy
- 12.7%
- Myocarditis deaths (1 from Jan 1, 2020, through Jun 30, 2022; none attributed to COVID-19)
- 8
Exertional SCD
- Exertional SCD events
- 50%
- Exertional with coronary artery anomalies
- 100%
- Exertional with arrhythmogenic cardiomyopathy
- 83%
Case identification by source
- NCAA resolutions list
- 117 of 143 (82%)
- Parent Heart Watch database or media reports
- 89 of 143 (62%)
- National Center for Catastrophic Sports Injury Research database
- 63 of 143 (44%)
- Insurance claims
- 27 of 143 (19%)
Original publication
Sudden Cardiac Death in National Collegiate Athletic Association Athletes: A 20-Year Study. Circulation. Published 13 November 2023. doi:10.1161/circulationaha.123.065908
Summarised from the published abstract; every number is checked against it