Incidence of Cardiac Arrest During Sports Among Women in the European Union

• Published in: Journal of the American College of Cardiology 2023-03, Vol.81 (11), p.1021-1031
• Main Authors: Weizman, Orianne, Empana, Jean-Philippe, Blom, Marieke, Tan, Hanno L., Jonsson, Martin, Narayanan, Kumar, Ringh, Mattias, Marijon, Eloi, Jouven, Xavier
• Format: Article
• Language: English
• Subjects: Cardiopulmonary Resuscitation - adverse effects; Death, Sudden, Cardiac - epidemiology; Europe; European Union; Female; Heart Arrest; Humans; Incidence; Life Sciences; Male; Medicin och hälsovetenskap; Out-of-Hospital Cardiac Arrest - epidemiology; Out-of-Hospital Cardiac Arrest - etiology; Out-of-Hospital Cardiac Arrest - therapy; sex; Sports; sudden cardiac death; women
• ISSN: 0735-1097; 1558-3597; 1558-3597
• DOI: 10.1016/j.jacc.2023.01.015

Women represent a growing proportion of sports participants. Still, few original data regarding sudden cardiac arrest during sports (Sr-SCA) in women are available. The authors sought to assess the incidence, characteristics, and outcomes of women presenting with Sr-SCA. Data were analyzed from 3 population-based European registries (ESCAPE-NET 2020 Horizon Program) that prospectively and exhaustively collect every case of SCA: SDEC (Paris-Sudden Death Expertise Center), ARREST (AmsteRdam REsuscitation Studies), and SRCR (Swedish Register for Cardiopulmonary Resuscitation). Sr-SCA was defined as SCA during or ≤1 hour after cessation of sports activity. Of 34,826 SCA between 2006 and 2017, 760 Sr-SCA (2.2%) were identified, including 54 in women. The average annual incidence of Sr-SCA in women in the 3 registries ranged from 0.10 per million (95% CI: 0.01-0.71 per million) to 0.38 per million (95% CI: 0.14-1.04 per million). Overall, the average annual incidence rate of Sr-SCA in women was 0.19 per million (95% CI: 0.14-0.24 per million), >10-fold lower compared with men (2.63 per million [95% CI: 2.45-2.83 per million]; P < 0.0001). When extrapolating to the total European population and accounting for age and sex, this yields 98 cases per year (95% CI: 72-123 cases per year) in women and 1,350 cases per year (95% CI: 1,256-1,451 cases per year) in men. Subject characteristics and circumstances of occurrence were similar in women vs men. Bystander response, time to defibrillation, and survival rate at hospital admission (58.8% vs 58.5%; P = 0.99) and 30 days did not differ significantly between women and men. These findings emphasize the dramatically lower risk of Sr-SCA in women compared with men, despite similar subject characteristics. This should be considered in designing preparticipation screening strategies in the future. [Display omitted]