Li Lingxia, Le Douairon Lahaye Solène, Ding Shuzhe, Schnell Frédéric
Sino-French Joint Research Center of Sport Science, College of Physical Education and Health, East China Normal University, Shanghai, China.
College of Physical Education and Health, East China Normal University, Shanghai, China.
Sports Med. 2025 Mar;55(3):697-712. doi: 10.1007/s40279-024-02163-5. Epub 2025 Jan 3.
Although many studies have demonstrated a lower incidence of sudden cardiac arrest or death (SCA/D) in female athletes than in male, there is limited understanding of the specific underlying causes.
This systematic review aimed to assess the disparities in SCA/D incidence between male and female competitive athletes and explore the associated etiologies.
A comprehensive search was conducted for retrospective and prospective studies examining SCA/D incidence in male and female athletes. Incidence and incidence rate ratios (IRRs) according to sex were evaluated.
Among the 16 studies analyzed, 1797 cases of SCA/D were observed; 1578 occurred in males (87.81%). Ages ranged from adolescent to adult. The incidence was 1.42/100,000 athlete-years (AY) in males (95% CI 0.97-2.09), and 0.32/100,000 AY in females (95% CI 0.17-0.59), resulting in an IRR of 5.55. When considering athletes aged ≤ 35 years, the incidence was 1.46/100,000 AY in males (95% CI 0.91-2.34) and 0.30/100,000 AY in females (95% CI 0.14-0.66), with an IRR of 5.47. The IRR was 5.13 (95% CI 3.94-6.67) for the most recent studies with athletes enrolled only after the year 2000, versus 6.02 (95% CI 4.59-7.90) for the remaining studies covering all observed years. Hypertrophic cardiomyopathy (HCM) was the predominant cause among males (45.12%), while congenital coronary anomalies were more prevalent in females (33.04%).
The incidence of SCA/D in females was approximately 6 times lower than in males, with sex differences also in the leading causes of SCA/D. Understanding these discrepancies could lead to targeted strategies for the prevention of SCD in athletes.
(PROSPERO 2023 CRD42023432022)/05.07.2023.
尽管许多研究表明，女性运动员心脏骤停或猝死（SCA/D）的发生率低于男性，但对其具体潜在原因的了解有限。
本系统评价旨在评估男女竞技运动员SCA/D发生率的差异，并探讨相关病因。
对检查男女运动员SCA/D发生率的回顾性和前瞻性研究进行全面检索。评估按性别划分的发病率和发病率比值（IRR）。
在分析的16项研究中，观察到1797例SCA/D病例；1578例发生在男性中（87.81%）。年龄范围从青少年到成年人。男性的发病率为1.42/100,000运动员年（AY）（95%CI 0.97-2.09），女性为0.32/100,000 AY（95%CI 0.17-0.59），发病率比值为5.55。考虑年龄≤35岁的运动员时，男性发病率为1.46/100,000 AY（95%CI 0.91-2.34），女性为0.30/100,000 AY（95%CI 0.14-0.66），发病率比值为5.47。对于2000年后仅纳入运动员的最新研究，发病率比值为5.13（95%CI 3.94-6.67），而涵盖所有观察年份的其余研究为6.02（95%CI 4.59-7.90）。肥厚型心肌病（HCM）是男性中主要病因（45.12%），而先天性冠状动脉异常在女性中更常见（33.04%）。
女性SCA/D的发生率比男性低约6倍，SCA/D的主要病因也存在性别差异。了解这些差异可能会带来预防运动员心源性猝死的针对性策略。
（PROSPERO 2023 CRD42023432022）/2023年7月5日。
