Date Published: March 28, 2017
Publisher: Public Library of Science
Author(s): Babken Asatryan, Cristina Vital, Christoph Kellerhals, Argelia Medeiros-Domingo, Christoph Gräni, Lukas D. Trachsel, Christian M. Schmied, Ardan M. Saguner, Prisca Eser, David Herzig, Stephan Bolliger, Katarzyna Michaud, Matthias Wilhelm, Nanette H Bishopric.
In Switzerland, ECG screening was first recommended for national squad athletes in 1998. Since 2001 it has become mandatory in selected high-risk professional sports. Its impact on the rates of sports-related sudden cardiac death (SCD) is unknown.
We aimed to study the incidence, causes and time trends of sports-related SCD in comparison to SCD unrelated to exercise in Switzerland.
We reviewed all forensic reports of SCDs of the German-speaking region of Switzerland in the age group of 10 to 39 years, occurring between 1999 and 2010. Cases were classified into three categories based on whether or not deaths were associated with sports: no sports (NONE), recreational sports (REC), and competitive sports (COMP).
Over the 12-year study period, 349 SCD cases were recorded (mean age 30±7 years, 76.5% male); 297 cases were categorized as NONE, 31 as REC, and 21 as COMP. Incidences of SCD per 100,000 person-years [mean (95% CI)] were the lowest in REC [0.43 (0.35–0.56)], followed by COMP [1.19 (0.89–1.60)] and NONE [2.46 (2.27–2.66)]. In all three categories, coronary artery disease (CAD) with or without acute myocardial infarction (MI) was the most common cause of SCD. Three professional athletes were identified in COMP category which all had SCD due to acute MI. There were no time trends, neither in overall, nor in cause-specific incidences of SCD.
The incidence of SCD in young individuals in Switzerland is low, both related and unrelated to sports. In regions, like Switzerland, where CAD is the leading cause of SCD associated with competitions, screening for cardiovascular risk factors in addition to the current PPS recommendations might be indicated to improve detection of silent CAD and further decrease the incidence of SCD.
Sudden cardiac death (SCD) in the young and apparently healthy individuals is a devastating event with enormous impact on community health . Reduction of cardiovascular mortality is expected due to growing increase in awareness of risk factors over the past few decades, but the SCD burden worldwide is still huge . Despite numerous reports on the topic, our knowledge about the precise incidence, demographics, causes and circumstances surrounding the issue remain limited, as do regional differences .
The incidence of SCD in the German-speaking part of Switzerland was low. CAD was the predominant cause of SCD in sports-related and unrelated categories. Screening for cardiovascular risk factors such as tobacco smoking, hypertension, dyslipidaemia, and family history of premature CAD in addition to the current PPS recommendations might be indicated to improve detection of silent CAD and further decrease the incidence of SCD.