Kim Jonathan H, Rim Austin J, Miller James T, Jackson Mekensie, Patel Neeya, Rajesh Sanchitha, Ko Yi-An, DiGregorio Heather, Chiampas George, McGillivray David, Holder Jay, Baggish Aaron L
Emory Clinical Cardiovascular Research Institute, Emory School of Medicine, Atlanta, Georgia.
Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
JAMA. 2025 May 20;333(19):1699-1707. doi: 10.1001/jama.2025.3026.
More than 29 million participants completed marathons and half-marathons in the US between 2010-2023, approximately 3 times the number from 2000-2009. Contemporary long-distance race-related cardiac arrest incidence and outcomes are unknown.
To determine the incidence and outcomes of cardiac arrests during US marathons and half-marathons between 2010-2023 from a record of race finishers and a comprehensive review of cases from media reports, direct contact with race directors, USA Track & Field claims, and interviews with survivors or next of kin.
DESIGN, SETTING, AND PARTICIPANTS: Observational case series from the Race Associated Cardiac Event Registry; cohort data from US marathon and half-marathon runners from January 1, 2010, to December 31, 2023. Case profiles were reviewed to determine etiology and factors associated with survival. Incidence and etiology data were compared with historical reference standards (2000-2009).
Recreational long-distance running (marathon and half-marathon distance).
Incidence proportions of sudden cardiac arrest and death.
Among 29 311 597 race finishers, 176 cardiac arrests (127 men, 19 women, 30 sex unknown) occurred during US long-distance running races. Compared with 2000-2009, cardiac arrest incidence remained unchanged (incidence rate, 0.54 per 100 000 participants [95% CI, 0.41-0.70] vs 0.60 per 100 000 [95% CI, 0.52-0.70], respectively). However, there were significant declines in cardiac death incidence (0.20 per 100 000 [95% CI, 0.15-0.26] vs 0.39 per 100 000 [95% CI, 0.28-0.52]) and case fatality rate (34% vs 71%). Cardiac arrests remained more common among men (1.12 per 100 000 [95% CI, 0.95-1.32]) than women (0.19 per 100 000 [95% CI, 0.13-0.27]) and during the marathon (1.04 per 100 000 [95% CI, 0.82-1.32]), compared with the half-marathon (0.47 per 100 000 [95% CI, 0.38-0.57]). Among runners for which a definitive cause of cardiac arrest could be determined (n = 67/128 [52%]), coronary artery disease rather than hypertrophic cardiomyopathy was the most common etiology. Decreased cardiopulmonary resuscitation time and an initial ventricular tachyarrhythmia rhythm were associated with survival.
Despite increased participation in US long distance running races, cardiac arrest incidence remains stable. There has been a marked decline in cardiac arrest mortality, and coronary artery disease was the most common etiology among cases with sufficient cause-related data. Effective emergency action planning with immediate access to defibrillation may explain the improvement in survival.
2010年至2023年期间，超过2900万参与者在美国完成了马拉松和半程马拉松比赛，这一数字约为2000年至2009年期间的3倍。目前尚不清楚当代与长跑比赛相关的心脏骤停发生率及后果。
通过比赛完赛者记录以及对媒体报道、与赛事总监直接沟通、美国田径协会索赔记录和对幸存者或近亲访谈等收集的病例进行全面回顾，确定2010年至2023年期间美国马拉松和半程马拉松比赛中心脏骤停的发生率及后果。
设计、背景和参与者：来自与比赛相关心脏事件登记处的观察性病例系列；2010年1月1日至2023年12月31日期间美国马拉松和半程马拉松跑者的队列数据。对病例资料进行审查以确定病因及与生存相关的因素。将发生率和病因数据与历史参考标准（2000年至2009年）进行比较。
休闲长跑（马拉松和半程马拉松距离）。
心脏骤停和死亡的发生率。
在29311597名完赛者中，美国长跑比赛期间发生了176例心脏骤停（127名男性、19名女性、30名性别未知）。与2000年至2009年相比，心脏骤停发生率保持不变（发生率分别为每100000名参与者0.54例[95%CI，0.41 - 0.70]和每100000名参与者0.60例[95%CI，0.52 - 0.70]）。然而，心脏性死亡发生率（每100000名参与者0.20例[95%CI，0.15 - 0.26]与每100000名参与者0.39例[95%CI，0.28 - 0.52]）和病死率（34%与71%）均显著下降。心脏骤停在男性中（每100000名参与者1.12例[95%CI，0.95 - 1.32]）比女性中（每100000名参与者0.19例[95%CI，0.13 - 0.27]）更常见，并且在马拉松比赛期间（每100000名参与者1.04例[95%CI，0.82 - 1.32]）比半程马拉松比赛期间（每100000名参与者0.47例[95%CI，0.38 - 0.57]）更常见。在能够确定心脏骤停明确病因的跑步者中（n = 67/128[52%]），冠状动脉疾病而非肥厚型心肌病是最常见的病因。心肺复苏时间缩短和初始室性快速心律失常节律与生存相关。
尽管美国长跑比赛的参与人数增加，但心脏骤停发生率保持稳定。心脏骤停死亡率显著下降，在有足够病因相关数据的病例中，冠状动脉疾病是最常见的病因。有效的应急行动计划以及能立即使用除颤器可能解释了生存率的提高。
