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. Au vu de l’association connue entre le SARS-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 ACS
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’ACS 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 ACS 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
Publication stage
In Press Journal Pre-ProofFootnotes
See page 8 for disclosure information.
Identification
Copyright
© 2022 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
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