TY - JOUR

T1 - Toxicology Screening in Sports-Related Sudden Cardiac Death

T2 - A Multinational Observational Study

AU - Hansen, Carl J

AU - Svane, Jesper

AU - Palsøe, Marie K

AU - Isbister, Julia C

AU - Paratz, Elizabeth

AU - Molina, Pilar

AU - Morentin, Benito

AU - Winkel, Bo G

AU - La Gerche, André

AU - Linnet, Kristian

AU - Banner, Jytte

AU - Lucena, Joaquin

AU - Semsarian, Christopher

AU - Tfelt-Hansen, Jacob

N1 - Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.

PY - 2024

Y1 - 2024

N2 - BACKGROUND: Knowledge of toxicological findings among sports-related sudden cardiac death (SrSCD) is scarce.OBJECTIVES: This study aimed to describe postmortem toxicology findings in a multinational cohort of young SrSCD.METHODS: Patients with sudden cardiac death (SCD) aged 12 to 49 years with a complete post mortem were included from Denmark, Spain, and Australia. Postmortem findings were compared between SrSCD and non-SrSCD, and toxicology findings in SrSCD were assessed.RESULTS: We included 3,189 SCD, of which 219 (7%) were sports-related. SrSCD patients were younger (36 years vs 41 years; P < 0.001) and of male predominance (96% vs 75%; P < 0.001), and their death was more often caused by structural cardiac disease (68% vs 61%; P = 0.038). Positive toxicology screenings were significantly less likely among SrSCD than non-SrSCD (12% vs 43%; P < 0.001), corresponding to 82% lower odds of a positive toxicology screening in SrSCD. Patient characteristics were similar between SrSCDs with positive and negative toxicology screenings, but deaths were more often unexplained (59% vs 34%). Nonopioid analgesics were the most common finding (3%), and SCD-associated drugs were detected in 6% of SrSCD. SUD was more prevalent among the SrSCD with positive toxicology (59% vs 34%).CONCLUSIONS: Sports-related SCD mainly occurred in younger men with structural heart disease. They had a significantly lower prevalence of a positive toxicology screening compared with non-SrSCD, and detection of SCD-associated drugs was rare.

AB - BACKGROUND: Knowledge of toxicological findings among sports-related sudden cardiac death (SrSCD) is scarce.OBJECTIVES: This study aimed to describe postmortem toxicology findings in a multinational cohort of young SrSCD.METHODS: Patients with sudden cardiac death (SCD) aged 12 to 49 years with a complete post mortem were included from Denmark, Spain, and Australia. Postmortem findings were compared between SrSCD and non-SrSCD, and toxicology findings in SrSCD were assessed.RESULTS: We included 3,189 SCD, of which 219 (7%) were sports-related. SrSCD patients were younger (36 years vs 41 years; P < 0.001) and of male predominance (96% vs 75%; P < 0.001), and their death was more often caused by structural cardiac disease (68% vs 61%; P = 0.038). Positive toxicology screenings were significantly less likely among SrSCD than non-SrSCD (12% vs 43%; P < 0.001), corresponding to 82% lower odds of a positive toxicology screening in SrSCD. Patient characteristics were similar between SrSCDs with positive and negative toxicology screenings, but deaths were more often unexplained (59% vs 34%). Nonopioid analgesics were the most common finding (3%), and SCD-associated drugs were detected in 6% of SrSCD. SUD was more prevalent among the SrSCD with positive toxicology (59% vs 34%).CONCLUSIONS: Sports-related SCD mainly occurred in younger men with structural heart disease. They had a significantly lower prevalence of a positive toxicology screening compared with non-SrSCD, and detection of SCD-associated drugs was rare.

U2 - 10.1016/j.jacep.2023.11.006

DO - 10.1016/j.jacep.2023.11.006

M3 - Journal article

C2 - 38127009

VL - 10

SP - 515

EP - 523

JO - JACC: Clinical Electrophysiology

JF - JACC: Clinical Electrophysiology

SN - 2405-5018

IS - 3

ER -