Emory Study Finds Racial Gaps in Sudden Cardiac Arrest and Death Among Athletes

The Lancet review reveals racial disparities in sudden cardiac arrest among athletes, emphasizing the need for further research into social determinants of health to address these inequities.

A recent comprehensive review of data published by The Lancet, led by Emory sports cardiologist Dr. Jonathan Kim, reveals that Black athletes are about five times more likely to experience sudden cardiac arrest (SCA) and sudden cardiac death (SCD) than White athletes, despite some signs of an overall decrease in SCD rates. Historically, SCA and SCD have been major causes of death among athletes, especially those in high-intensity sports ().

Kim emphasizes that the differences in SCA/D rates underscore the importance of conducting more research on the social determinants of health in younger athletes, a subject that is still insufficiently explored.

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Analysis of National and International SCA/D Data

After examining a repository of national and international data focused on SCA/D in athletes accumulated over the last 30 years, Kim and colleagues from Lausanne University Hospital, Morristown Medical, Massachusetts General Hospital, and other prominent institutions reviewed the significant racial disparities that also persist in athlete electrocardiography (ECG) screenings, which have become a standard practice for competitive athletes.

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False Positives in ECG Screenings for Black Athletes

These screenings often yield more false positives in Black athletes, which means that athletes may be wrongly identified as having a serious heart condition. For those with limited access to comprehensive follow-up testing this is especially problematic as these individuals may face unnecessary stress and may not be able to receive follow-up care to confirm whether results are accurate.

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Factors Contributing to Health Disparities in Young Athletes

Social determinants of health, such as economic stability, proximity to health care facilities, access to health information, and experiences with discrimination can play a significant role in disparities in health outcomes, even in young athletes. By incorporating social determinants of health into future research, Kim says we may be better poised to understand how to mitigate the impacts on young athletes in particular.

“To truly address these disparities, it’s not enough to just screen for potential problems,” Kim says. “There needs to be an understanding on how to tackle the underlying social determinants of health that puts these athletes at a greater risk.”

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Importance of Pre-Participation Evaluation (PPE) in Athlete Safety

In the Lancet review, Kim and colleagues stress that proper management of sudden cardiac arrest in athletes starts with adequate pre-participation evaluation (PPE) which involves careful planning and sufficient resources. “We need to look for potential underlying health conditions. We also need to consider all the environmental stressors that young individuals have to deal with and also where they grow up,” says Kim. An effective PPE history and physical examination should include appropriate follow-up, especially if ECG is included and abnormalities detected.

The Need for Continued Advocacy and Action

Looking ahead, the growing focus on this topic marks a substantial shift. “Just five to ten years ago, I doubt many were thinking about social determinants of health and impacts on young athletes,” says Kim. Asking these critical questions is a major step in the right direction, moving forward it’s essential to continue raising these questions and taking action to address them.

Reference:

A contemporary review of sudden cardiac arrest and death in competitive and recreational athletes - (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)02086-5/abstract)

Source-Eurekalert