Department of Cardiology, Academic Medical Centre, University of Amsterdam, The Netherlands.
Eur Heart J. 2013 Dec;34(47):3616-23. doi: 10.1093/eurheartj/eht401. Epub 2013 Oct 3.
Although regular physical activity has beneficial cardiovascular effects, exercise can trigger an acute cardiac event. We aimed to determine the incidence and prognosis of exercise-related out-of-hospital cardiac arrest (OHCA) in the general population.
We prospectively collected all OHCAs in persons aged 10-90 years from January 2006 to January 2009 in the Dutch province North Holland. The relation between exercise during or within 1 h before OHCA and outcome was analysed using multivariable logistic regression, adjusted for age, gender, location, bystander witness, bystander cardiopulmonary resuscitation (CPR), automated external defibrillator (AED) use, initial rhythm, and Emergency Medical System response time. Of 2524 OHCAs, 143 (5.7%) were exercise related (7 ≤35 years, 93% men). Exercise-related OHCA incidence was 2.1 per 100 000 person-years overall and 0.3 per 100 000 person-years in those ≤35 years. Survival after exercise-related OHCA was distinctly better than after non-exercise related OHCA (46.2 vs. 17.2%) [unadjusted odds ratio (OR) 4.12; 95%CI 2.92-5.82; P < 0.001], even after adjustment for abovementioned variables (OR 2.63; 95%CI, 1.23-5.54; P = 0.01). In the 69 victims aged ≤35 years, exercise was not associated with better survival: 14.3 vs. 17.7% in non-exercise-related OHCA (OR 0.77; 95%CI 0.08-7.08; P = 0.82).
Exercise-related OHCA has a low incidence, particularly in the young. Cardiac arrests occurring during or shortly after exercise carry a markedly better prognosis than non-exercise-related arrests in persons >35 years. This study establishes the favourable outcome of exercise-related OHCA and should have direct implications for public health programs to prevent exercise-related sudden death.
尽管有规律的体育活动对心血管有益，但运动也可能引发急性心脏事件。我们旨在确定普通人群中与运动相关的院外心脏骤停（OHCA）的发生率和预后。
我们前瞻性地收集了 2006 年 1 月至 2009 年 1 月期间荷兰北荷兰省 10-90 岁人群的所有 OHCA。使用多变量逻辑回归分析了 OHCA 期间或之前 1 小时内运动与结局之间的关系，调整了年龄、性别、地点、旁观者目击者、旁观者心肺复苏（CPR）、自动体外除颤器（AED）使用、初始节律和急救医疗系统反应时间。在 2524 例 OHCA 中，有 143 例（5.7%）与运动有关（7≤35 岁，93%为男性）。总的来说，与运动相关的 OHCA 发生率为 2.1/100000 人年，≤35 岁者为 0.3/100000 人年。与非运动相关的 OHCA 相比，与运动相关的 OHCA 后生存率明显更好（46.2% vs. 17.2%）[未调整的优势比（OR）4.12；95%可信区间（CI）2.92-5.82；P <0.001]，即使在调整了上述变量后也是如此（OR 2.63；95%CI，1.23-5.54；P = 0.01）。在 69 名≤35 岁的患者中，运动与更好的生存率无关：非运动相关 OHCA 中为 14.3% vs. 17.7%（OR 0.77；95%CI 0.08-7.08；P = 0.82）。
与运动相关的 OHCA 发生率较低，尤其是在年轻人中。在>35 岁的人群中，发生在运动期间或运动后不久的心脏骤停预后明显好于非运动相关的骤停。本研究确立了与运动相关的 OHCA 的良好预后，这应直接影响预防与运动相关的猝死的公共卫生计划。
