Sudden cardiac arrest during sports activity in middle age.
Sudden cardiac arrest during sports activity in middle age.
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DOI：
10.1161/circulationaha.114.011988
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发表时间：
2015-04-21
期刊：
影响因子：
37.8
通讯作者：
Chugh SS
中科院分区：
文献类型：
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作者：
Marijon E;Uy-Evanado A;Reinier K;Teodorescu C;Narayanan K;Jouven X;Gunson K;Jui J;Chugh SS
运动相关的心脏骤停（SCA）大多发生在中年。我们试图确定的负担，特点和结果SCA在运动中的中年居民的一个大型美国社区。在一项大型、前瞻性、基于人群的研究（2002-2013年）中确定了35-65岁的SCA病例，并对其终生病史进行了系统和全面的评估。在1，247例SCA病例中，63例（5%）发生在体育活动期间，平均年龄为51.1±8.8岁，每年的发病率为21.7/100万（95%CI 8.1-35.4）。性别差异显著，男性运动SCA的发生率（RR 18.68，95%CI 2.50-139.56）高于其他SCA（RR 2.58，95%CI 2.12-3.13）。运动性SCA也更可能是目击事件（87 vs. 53%，P<0.001），心肺复苏（44 vs. 25%，P=0.001）和室颤（84 vs. 51%，P<0.0001）。运动相关性SCA患者的出院生存率较高（23.2% vs. 13.6%，P=0.04）。16%的运动性SCA病例存在已知的既存心脏病，56%存在≥1个心血管风险因素，总体而言，36%的病例在SCA前一周内有典型的心血管症状。中年时期与体育相关的SCA在总体SCA负担中所占比例相对较小，这强化了体育活动的高效益-低风险性质的观点。特别是鉴于目前的人口老龄化趋势，我们的研究结果强调，有针对性的教育可以最大限度地提高老年运动员对体育活动的安全性和接受度。
Sports-associated sudden cardiac arrests (SCAs) occur mostly during middle age. We sought to determine burden, characteristics, and outcomes of SCA during sports among middle aged residents of a large US community. SCA cases aged 35–65 years were identified in a large, prospective, population-based study (2002–2013), with systematic and comprehensive assessment of their lifetime medical history. Of the 1,247 SCA cases, 63 (5%) occurred during sports activities at a mean age of 51.1±8.8 years, yielding an incidence of 21.7 (95%CI 8.1–35.4) per million per year. The incidence varied significantly based on sex, with a higher incidence among men (RR 18.68 95%CI 2.50–139.56) for sports SCA, as compared to all other SCA (RR 2.58, 95%CI 2.12–3.13). Sports SCA was also more likely to be a witnessed event (87 vs. 53%, P<0.001), with cardiopulmonary resuscitation (44 vs. 25%, P=0.001) and ventricular fibrillation (84 vs. 51%, P<0.0001). Survival to hospital discharge was higher for sports-associated SCA (23.2 vs. 13.6%, P=0.04). Sports SCA cases presented with known pre-existing cardiac disease in 16%, ≥1 cardiovascular risk factor in 56%, and overall, 36% of cases had typical cardiovascular symptoms during the week preceding SCA. Sports-associated SCA in middle age represents a relatively small proportion of the overall SCA burden, reinforcing the idea of the high benefit-low risk nature of sports activity. Especially in light of current population aging trends, our findings emphasize that targeted education could maximize both safety and acceptance of sports activity in the older athlete.