Article Impact Level: HIGH Data Quality: STRONG Summary of The Lancet, 404(10468), 2209–2222. https://doi.org/10.1016/S0140-6736(24)02086-5 Dr. Jonathan H. Kim et al.
Points
- Black athletes are approximately five times more likely to experience sudden cardiac arrest (SCA) and sudden cardiac death (SCD) than White athletes, despite a general decline in SCD rates among all athletes.
- Electrocardiography (ECG) screenings often produce false positives in Black athletes, leading to unnecessary stress and potential barriers to follow-up care, particularly for those with limited access to healthcare resources.
- Factors such as economic stability, healthcare access, and experiences with discrimination significantly influence the increased risk of SCA/SCD among Black athletes, highlighting the role of social determinants of health.
- The study calls for integrating social determinants of health into research and improving management strategies, including thorough preparticipation evaluation (PPE) histories and physical examinations, for better care outcomes.
- This research underscores the urgent need to address racial disparities in cardiovascular risks among athletes by combining healthcare improvements with broader social interventions.
Summary
A recent study highlights the disparities in sudden cardiac arrest (SCA) and sudden cardiac death (SCD) among athletes, with a particular focus on racial differences. Led by Emory sports cardiologist Jonathan Kim, the study found that Black athletes are approximately five times more likely to experience SCA and SCD compared to their White counterparts. This disparity exists despite a general decline in SCD rates across all athletes. SCA and SCD have long been leading causes of death among athletes, especially in high-intensity sports, and understanding the underlying causes of these events remains critical for improving prevention and outcomes.
The study also examined racial disparities in the effectiveness of electrocardiography (ECG) screenings, commonly used as part of preparticipation evaluations (PPE) for athletes. ECGs in Black athletes are more likely to produce false positives, leading to unnecessary stress and potential barriers to follow-up care for those with limited access to healthcare resources. This issue is compounded by the social determinants of health, including economic stability, proximity to healthcare, and experiences with discrimination, which significantly impact the health outcomes of Black athletes, particularly the younger population. These factors, often overlooked, could contribute to the increased risk of SCA/SCD in this group.
Kim and colleagues emphasize that addressing these disparities requires a comprehensive approach beyond screening for heart conditions. The study stresses the importance of incorporating social determinants of health into future research to understand better their role in the increased risk of cardiovascular events in young athletes. Additionally, it calls for improved management strategies, including a thorough PPE history and physical examination, mainly when ECG abnormalities are detected, to ensure adequate follow-up care. This review marks a pivotal shift in addressing the intersection of healthcare, race, and athletics, calling for further action to mitigate these disparities.
Link to the article: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)02086-5/abstract
References Kim, J. H., Martinez, M. W., Guseh, J. S., Krishnan, S., Gray, B., Harmon, K. G., Papadakis, M., Phelan, D. M., Stewart, K., Levine, B. D., & Baggish, A. L. (2024). A contemporary review of sudden cardiac arrest and death in competitive and recreational athletes. The Lancet, 404(10468), 2209–2222. https://doi.org/10.1016/S0140-6736(24)02086-5
