Cited by 1,311Cardiovascular Effects of ExerciseCardiac electrophysiology and arrhythmiasCardiomyopathy and Myosin Studies

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Does sports activity enhance the risk of sudden death in adolescents and young adults?

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Corrado, Domenico, Basso, Cristina, Rizzoli, Giulio, Schiavon, Maurizio, Thiene, Gaetano·2003·Journal of the American College of Cardiology

DOI 10.1016/j.jacc.2003.03.002

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Abstract

Objectives We sought to assess the risk of sudden death (SD) in both male and female athletes age 12 to 35 years.Background Little is known about the risk of SD in adolescents and young adults engaged in sports.Methods We did a 21-year prospective cohort study of all young people of the Veneto Region of Italy. From 1979 to 1999, the total population of adolescents and young adults averaged 1,386,600 (692,100 males and 694,500 females), of which 112,790 (90,690 males and 22,100 females) were competitive athletes. An analysis by gender of risk of SD and underlying pathologic substrates was performed in the athletic and non-athletic populations.Results There were 300 cases of SD, producing an overall cohort incidence rate of 1 in 100,000 persons per year. Fifty-five SDs occurred among athletes (2.3 in 100,000 per year) and 245 among non-athletes (0.9 in 100,000 per year), with an estimated relative risk (RR) of 2.5 (95% confidence interval [CI] 1.8 to 3.4; p < 0.0001). The RR of SD among athletes versus non-athletes was 1.95 (CI 1.3 to 2.6; p = 0.0001) for males and 2.00 (CI 0.6 to 4.9; p = 0.15) for females. The higher risk of SD in athletes was strongly related to underlying cardiovascular diseases such as congenital coronary artery anomaly (RR 79, CI 10 to 3,564; p < 0.0001), arrhythmogenic right ventricular cardiomyopathy (RR 5.4, CI 2.5 to 11.2; p < 0.0001), and premature coronary artery disease (RR 2.6, CI 1.2 to 5.1; p = 0.008).Conclusions Sports activity in adolescents and young adults was associated with an increased risk of SD, both in males and females. Sports, per se, was not a cause of the enhanced mortality, but it triggered SD in those athletes who were affected by cardiovascular conditions predisposing to life-threatening ventricular arrhythmias during physical exercise.

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Authors: Corrado, D., Basso, C., Rizzoli, G., Schiavon, M., & Thiene, G.
Affiliations: University of Padua (IT)
Corresponding author: Thiene, Gaetano
ORCID: Corrado, Domenico
Basso, Cristina
Schiavon, Maurizio
Thiene, Gaetano
Venue: Journal of the American College of Cardiology
Publisher: Elsevier BV
Published: 2003-12
Volume: 42
Issue: 11
Pages: 1959-1963
ISSN: 0735-1097 (ISSN-L)
DOI: 10.1016/j.jacc.2003.03.002
OpenAlex: W2096363558
Cited by: 1,311
References: 17
Citations by year: 2026: 41 · 2025: 46 · 2024: 52 · 2023: 65 · 2022: 49 · 2021: 72 · 2020: 80 · 2019: 48 · 2018: 70 · 2017: 70 · 2016: 78 · 2015: 84 · 2014: 81 · 2013: 68 · 2012: 77
FWCI: 19.62
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 3552 d)
Locations: Journal of the American College of Cardiology (publishedVersion)
PubMed (publishedVersion)
Padua Research Archive (University of Padova) (submittedVersion)
Funders: European Commission
Regione del Veneto
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Effects of Exercise
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiomyopathy and Myosin Studies
Keywords: sudden death, athletes, adolescents, young adults, sports participation, arrhythmogenic right ventricular cardiomyopathy, congenital coronary anomaly, premature coronary artery disease, cardiovascular risk factors, sex differences, sudden cardiac death risk, relative risk, incidence rates, mortality risk factors, sports injuries
MeSH terms: Adolescent, Adult, Arrhythmias, Cardiac, Child, Female, Humans, Italy, Male, Prospective Studies, Sports, Cohort Studies, Death, Sudden, Cardiac

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Does sports activity enhance the risk of sudden death in adolescents and young adults?

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