Low Risk of Cardiac Arrest in Marathon Runners

Risk higher in marathons than half-marathons and in men with underlying cardiovascular disease

THURSDAY, Jan. 12 (HealthDay News) -- While the overall risk of cardiac arrest during a marathon or half-marathon is low, the risk is higher for those participating in marathons than half-marathons and for men than women, particularly for men with underlying hypertrophic cardiomyopathy or atherosclerotic coronary disease, according to a study published in the Jan. 12 issue of the New England Journal of Medicine.

Jonathan H. Kim, M.D., of Massachusetts General Hospital and Harvard Medical School in Boston, and colleagues sought to determine the incidence and outcomes of cardiac arrest in individuals participating in marathon and half-marathon races by interviewing survivors and next of kin of nonsurvivors, reviewing charts, and analyzing autopsy results.

The researchers found that, overall, 59 out of 10.9 million runners had a cardiac arrest during a race, for an incidence rate of 0.54 per 100,000 participants. Of these, 71 percent were fatal. The incidence of cardiac arrest was higher in marathons compared with half-marathons (1.01 versus 0.27 per 100,000). Rates were also much higher in men (0.90 per 100,000) than in women (0.16 per 100,000). The strongest predictors of survival included an underlying diagnosis other than hypertrophic cardiomyopathy or the initiation of cardiopulmonary resuscitation by a bystander.

"Findings from the Race Associated Cardiac Arrest Event Registry initiative indicate that marathons and half-marathons are associated with a low overall risk of cardiac arrest or sudden death. However, event rates have risen over the past decade among male marathon runners. Clinicians evaluating potential race participants should be aware of the risks of hypertrophic cardiomyopathy and atherosclerotic disease in this patient population," the authors write.

Several authors disclosed financial relationships with pharmaceutical companies.

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