Abstract
Background
The incidence of sports-related sudden cardiac death (SrSCD) attributable to myocarditis
is unknown. With the known association between SARS-CoV-2 (COVID-19) and myocarditis,
an understanding of pre-pandemic rates of SrSCD due to myocarditis will be important
in assessing a change of risk in the future. The objective was to ascertain the incidence
of SrSCD or aborted sudden cardiac death (SCD) attributable to myocarditis in the
general population.
Methods
A literature search through PubMed/Medline and Ovid/Embase was completed. Studies
of SrSCD with autopsy data or clear-cause aborted SrSCD were included. SrSCD was defined
as SCD which occurred within 1 hour of exercise. Data were abstracted by 2 independent
reviewers using the MOOSE guidelines. Risk assessment was performed with the Joanna
Briggs Institute Critical Appraisal Checklist for Prevalence Studies. Random-effects
models were used to report the incidence and 95% CIs. The primary outcome was the
incidence of SrSCD attributable to myocarditis, and the secondary outcome was SrSCD
overall.
Results
Fifteen studies were included comprising 347,092,437 person-years (PY). There were
1955 SrSCD or aborted SrSCD overall with an incidence of 0.93 (95% CI 0.47-1.82) per
100,000 PY. Fifty-three SrSCD were attributed to myocarditis with an incidence of
0.047 (95% CI 0.018-0.123) per 100,000 PY, or 1 death attributable to myocarditis
in 2.13 million PY.
Conclusions
In this meta-analysis, the overall incidence of SrSCD was low. Furthermore, SrSCD
attributed to myocarditis is exceedingly rare.
Résumé
Contexte
L’incidence de l’arrêt cardiaque subit lié à la pratique sportive (ACSs) et attribuable
à une myocardite reste inconnue. Avec l’association connue entre le SRAS-CoV-2 (COVID-19)
et la myocardite, il serait important de connaître le taux prépandémique d’ACSs attribuables
à une myocardite pour évaluer l’évolution du risque. L’objectif était de vérifier
l’incidence de l’ACSs ou de l’arrêt cardiaque subit (ACS) avorté attribuable à une
myocardite dans la population générale.
Méthodologie
Une recherche documentaire dans PubMed/Medline et Ovid/Embase a été réalisée. Elle
comprenait les études portant sur les ACSs et leurs rapports d’autopsie ou les ACSs
avortés et de cause évidente. L’ACSs y était défini comme un ACS survenant dans la
première heure d’une activité physique. Deux examinateurs indépendants ont recueilli
les données selon les lignes directrices MOOSE. Une évaluation du risque a été réalisée
à partir de la liste de vérification du Joanna Briggs Institute pour l’évaluation
critique des études sur la prévalence. Des modèles à effets aléatoires ont servi à
calculer l’incidence et les intervalles de confiance (IC) à 95 %. L’incidence de l’ACSs
attribuable à une myocardite constituait le critère principal et l’ACSs en général,
le critère secondaire.
Résultats
L’analyse portait sur quinze études regroupant 347 092 437 années-personnes (AP).
Elle a permis de recenser un total de 1 955 ACSs ou ACSs avortés, soit une incidence
de 0,93 (IC à 95 %; 0,47-1,82) pour 100 000 AP. Cinquante-trois ACSs ont été attribués
à une myocardite, soit une incidence de 0,047 (IC à 95 %; 0,018-0,123) pour 100 000
AP, ce qui représente une mort attribuable à la myocardite pour 2,13 millions d’AP.
Conclusions
Il ressort de cette méta-analyse que l’incidence de l’ACSs est faible. De plus, les
cas d’ACSs attribuables à une myocardite sont extrêmement rares.
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Article info
Publication history
Published online: July 15, 2022
Accepted:
July 8,
2022
Received:
March 31,
2022
Footnotes
See editorial by Dorian et al., pages 1693–1696 of this issue.
See page 1691 for disclosure information.
Identification
Copyright
© 2022 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
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- Sport, Myocarditis, and Sudden Death: A Perfect Storm?Canadian Journal of CardiologyVol. 38Issue 11
