Key Takeaways:
- Survival from sudden cardiac arrest among young competitive athletes increased significantly from 38% to 66% over the last decade, driven by enhanced emergency preparedness and improved access to CPR and AEDs.
- Persistent racial disparities remain a critical concern, with Black athletes having significantly lower survival rates (43%) compared to White athletes (68%), emphasizing the need for equitable emergency response resources and strategies across all athletic environments.
Survival rates after sudden cardiac arrest (SCA) in young competitive athletes have significantly improved over the past decade, yet notable racial disparities remain, according to new findings presented at the American College of Cardiology’s Annual Scientific Session (ACC.25) and published simultaneously in the Journal of the American College of Cardiology (JACC). The observational study analyzed outcomes in 641 young athletes (mean age 17 years, 85% male) who experienced SCA between 2014 and 2023, reporting an overall survival rate of 49%, with survival increasing significantly from 38% in 2014–2015 to 66% in 2022–2023 (p=0.007).
The study found that survival from exertional SCA was higher during competitions compared to practices (70% vs. 53%; p=0.001), likely due to better access to rapid emergency response, including automated external defibrillators (AEDs) and bystander CPR. Among sports, athletes participating in baseball had the highest survival rate at 88%, while football (47%) and swimming (46%) athletes had the lowest, highlighting the need for improved emergency preparedness in certain disciplines.
However, significant racial disparities were observed, with Black athletes demonstrating notably lower survival rates (43%) compared to White athletes (68%). After adjusting for sex and level of competition, Black race was independently associated with lower survival (RR 0.63; 95% CI 0.53–0.76; p<0.0001). Similarly, athletes classified as other non-White, non-Black races also showed reduced survival (RR 0.69; 95% CI 0.50–0.94; p=0.02).
“It’s exciting that we’ve seen survival improve over the last decade, likely because of ongoing efforts to improve emergency preparedness including the recognition of sudden cardiac arrest and increases in AED distribution and CPR training,” said Bradley J. Petek, MD, a sports cardiologist at Oregon Health & Science University in Portland, Oregon, and the study’s first author. “However, the disparities that we see in survival, especially in athletes of Black race or other non-White, non-Black race, are important and warrant further research. Black athletes’ higher risk of having a sudden cardiac arrest coupled with a lower likelihood of survival is deeply troubling.”
“Hopefully this will lead to broader scale training on sudden cardiac arrest awareness, CPR training and AED distribution, because it can happen literally anywhere,” Petek said. “We need to broaden our lens beyond school and professional teams and well-resourced areas, and drive policy to try to improve emergency preparedness for all athletes in all locations.”