发信人: gg2 (Allison), 信区: Running
标  题: 马拉松和心脏骤停
发信站: BBS 未名空间站 (Sun Jan  8 22:10:31 2012, 美东)

刚刚看到New England Journal of Medicine 上的最新的1/12期上的一篇文章，题目“
cardiac arrest during long-distance running races", 他们研究了从1/1/2000 到5
/31/2010中美国所有的马拉松和半程马拉松比赛中心脏骤停的病例，发现

1）马拉松和半程马拉松运动员的心脏骤停和猝死的危险性比一般人群低 （好消息吧）
2）心脏骤停主要归因于肥厚性心肌病或冠心病，特别是男性 （一般人群中也是男性的
风险大于女性）。文章最后建议要对运动员在比赛前对肥厚性心肌病或冠心病进行风险
评估
3）心脏骤停发生次数在这个10年中要比以往要多（同意文章的讨论中提到的这是因为
参加的人数在增加）

Original Article

Cardiac Arrest during Long-Distance Running Races

N Engl J Med 2012; 366:130-140January 12, 2012

Background

Approximately 2 million people participate in long-distance running races in the United States annually. Reports of race-related cardiac arrests have generated concern about the safety of this activity.

Methods

We assessed the incidence and outcomes of cardiac arrest associated with marathon and half-marathon races in the United States from January 1, 2000, to May 31, 2010. We determined the clinical characteristics of the arrests by interviewing survivors and the next of kin of nonsurvivors, reviewing medical records, and analyzing postmortem data.

Results

Of 10.9 million runners, 59 (mean [±SD] age, 42±13 years; 51 men) had cardiac arrest (incidence rate, 0.54 per 100,000 participants; 95% confidence interval [CI], 0.41 to 0.70). Cardiovascular disease accounted for the majority of cardiac arrests. The incidence rate was significantly higher during marathons (1.01 per 100,000; 95% CI, 0.72 to 1.38) than during half-marathons (0.27; 95% CI, 0.17 to 0.43) and among men (0.90 per 100,000; 95% CI, 0.67 to 1.18) than among women (0.16; 95% CI, 0.07 to 0.31). Male marathon runners, the highest-risk group, had an increased incidence of cardiac arrest during the latter half of the study decade (2000–2004, 0.71 per 100,000 [95% CI, 0.31 to 1.40]; 2005–2010, 2.03 per 100,000 [95% CI, 1.33 to 2.98]; P=0.01). Of the 59 cases of cardiac arrest, 42 (71%) were fatal (incidence, 0.39 per 100,000; 95% CI, 0.28 to 0.52). Among the 31 cases with complete clinical data, initiation of bystander-administered cardiopulmonary resuscitation and an underlying diagnosis other than hypertrophic cardiomyopathy were the strongest predictors of survival.

Conclusions

Marathons and half-marathons are associated with a low overall risk of cardiac arrest and sudden death. Cardiac arrest, most commonly attributable to hypertrophic cardiomyopathy or atherosclerotic coronary disease, occurs primarily among male marathon participants; the incidence rate in this group increased during the past decade.



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※ 修改:·gg2 於 Jan 12 20:13:36 2012 修改本文·[FROM: 24.146.]
※ 来源:·WWW 未名空间站 海外: mitbbs.com 中国: mitbbs.cn·[FROM: 24.146.]