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Journal Article

Citation

Hansen CJ, Svane J, Palsøe MK, Isbister JC, Paratz E, Molina P, Morentin B, Winkel BG, La Gerche A, Linnet K, Banner J, Lucena J, Semsarian C, Tfelt-Hansen J. JACC Clin. Electrophysiol. 2023; ePub(ePub): ePub.

Copyright

(Copyright © 2023, American College of Cardiology, Publisher Elsevier Publishing)

DOI

10.1016/j.jacep.2023.11.006

PMID

38127009

Abstract

BACKGROUND: Knowledge of toxicological findings among sports-related sudden cardiac death (SrSCD) is scarce.

OBJECTIVES: This study aimed to describe postmortem toxicology findings in a multinational cohort of young SrSCD.

METHODS: Patients with sudden cardiac death (SCD) aged 12 to 49 years with a complete post mortem were included from Denmark, Spain, and Australia. Postmortem findings were compared between SrSCD and non-SrSCD, and toxicology findings in SrSCD were assessed.

RESULTS: We included 3,189 SCD, of which 219 (7%) were sports-related. SrSCD patients were younger (36 years vs 41 years; P < 0.001) and of male predominance (96% vs 75%; P < 0.001), and their death was more often caused by structural cardiac disease (68% vs 61%; P = 0.038). Positive toxicology screenings were significantly less likely among SrSCD than non-SrSCD (12% vs 43%; P < 0.001), corresponding to 82% lower odds of a positive toxicology screening in SrSCD. Patient characteristics were similar between SrSCDs with positive and negative toxicology screenings, but deaths were more often unexplained (59% vs 34%). Nonopioid analgesics were the most common finding (3%), and SCD-associated drugs were detected in 6% of SrSCD. SUD was more prevalent among the SrSCD with positive toxicology (59% vs 34%).

CONCLUSIONS: Sports-related SCD mainly occurred in younger men with structural heart disease. They had a significantly lower prevalence of a positive toxicology screening compared with non-SrSCD, and detection of SCD-associated drugs was rare.


Language: en

Keywords

epidemiology; forensic pathology; exercise; sports cardiology; sudden cardiac death; toxicology

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