Survival Outcomes after Sudden Cardiac Arrest in Young Competitive Athletes from the United States (JACC April 2025-2)-Article: Survival Outcomes after Sudden Cardiac Arrest in Young Competitive Athletes from the United States

Article: Survival Outcomes after Sudden Cardiac Arrest in Young Competitive Athletes from the United States

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The study investigates survival outcomes following sudden cardiac arrest (SCA) in young competitive athletes in the United States over a nine-year period (2014-2023). SCA is the leading cause of death in this demographic during sports and exercise. This research aimed to analyze survival outcomes based on racial and exertional status differences.

Key findings include:

1. <strong>Overall survival:</strong> The study identified 641 cases of SCA, with a mean age of 17 years, predominantly male (85%). The overall survival rate was 49%, with better outcomes (57%) for SCAs occurring during exercise compared to rest or sleep.

2. <strong>Trends over time:</strong> Survival from SCA increased throughout the study period, ranging from 30% to 66% annually. Exertional SCA survival also improved, showing positive growth from 38% to 72% annually.

3. <strong>Racial disparities:</strong> Black athletes had lower survival rates (43%) compared to White athletes (68%). The study also noted other racial groups experiencing similar disparities, highlighting a need for focused prevention strategies.

4. <strong>Exertional vs nonexertional SCA:</strong> Survival from SCAs during games or competitions was higher (70%) than during practice or training (53%). Nonexertional SCAs showed lower survival (27%) and did not exhibit significant annual improvement trends.

5. <strong>Sport and Etiology Insights:</strong> Football and swimming had the lowest survival rates, while baseball showed the highest. Hypertrophic cardiomyopathy was identified as the most common cause of SCA/SCD.

These outcomes underscore the importance of increased emergency preparedness, such as the availability of automated external defibrillators (AEDs) and education on CPR across all sporting events. The study advocates for comprehensive emergency action plans, addressing racial disparities, and socio-economic factors impacting survival rates to improve athlete safety.

Overall, while survival rates have improved, significant work remains in addressing racial and resource-driven disparities for equitable healthcare outcomes in sports environments.

Keywords

sudden cardiac arrest

young athletes

survival outcomes

racial disparities

exertional status

emergency preparedness

automated external defibrillators

hypertrophic cardiomyopathy

sports safety

healthcare equity