Cardiac deaths in Marathons much lower than previously thought.
There is no dispute that heart attacks in road races make for spectacular headlines. Within the mainstream media, heart attack incidences drive more column inches than a major story like Ryan Hall running a mind-blowing 2:04+ marathon in Boston last year. This morbid fascination is not new. nor is the focus on one downed individual in a race of thousands.In 1985. the New York City Marathon suffered its first death of a runner due to a heart attack. Pushed to comment, then-race director Fred Leb-ow, distraught beyond words, put perspective on the issue of one person dying amongst approximately 100,000 New York City Marathon finishers up to that point. "Put 100,000 golfers in the same room and one is bound to die of a heart attack."
Previous studies on heart attack incidences in marathons and half marathons have been limited in scope, but nonetheless the data has been disconcerting in that runners, presumably healthy individuals, can experience heart attacks in running events. On January 12, the results and analysis of a significant study were published in the New EnglandJournal ofMedicine, a study of 10.9 million runners who participated in the marathon or half marathon in the United States between 2000 and 2010. The data demonstrates, from the standpoint of heart attack incidences, that the sport of distance running is much safer than it was once thought (see abstract on page 8).
Aaron Baggish, Ml), senior author of the study and cardiologist for the Boston Marathon, summarized that there are three takeawavs from the study. "Number one, from a cardiac arrest perspective, distance running is a safer sport than previously thought," Dr. Baggish said in a presentation given at the World Road Race Medical Society's Houston medical meeting on January 13 (formerly ARRMS - American Road Race Medical Society). "Second, although it is a safe sport, you should find your personal risk factor profile. And third, when someone goes down, the most important thing is bystander CPR." in essence, based on the dala, a heart attack sufferer's chance of surviving a heart attack during a road race actually is far belter than average because of the preponderance of immediate first-respond-ers running in their midst.
"In our study, we analyzed 59 cardiac arrests in marathons and half mai athons in a total of 10.9 million finishers," said Dr. Baggish, who runs a program for athletes with heart issues at: Massachusetts General Hospital. "This resulted in 42 deaths, which is a 30 percent survival rate. A race is probably the best place to have cardiac arrest."
Dr. Baggish said he had been collecting data on his own for the better part of the last decade, so the study was an extension of that volume of information. What was particularly bothersome to him was the huge amount of publicity that deaths in races bring, a disproportionate amount of publicity in his opinion "The tragedy of it is that there are 10 articles on cardiac arrest versus one on the positive impacts of the race," Dr. Bag-gish explained. "I was hoping to create a message that was very useful and positive."
That message came in the form of his massive study. Prior to Dr. Haggish s team's conclusions, the two most noled and quoted studies on cardiac arrest and running races were conducted by Bill Roberts in 1996 and 2005. "His study looked at data from the Twin Cities Marathon and Marine Coqs Marathon," Dr. Baggish noted. "His limitations were the small case count, isolated cases. The 1996 report studied four deaths in 212,000 runners, or one death in 50,000. The 2005 report studied nine cardiac arrests, five fatal, in 400,000 runners or one death in 100,000."
[ILLUSTRATION OMITTED]
By searching media reports on cardiac incidences and diligently contacting medical stall of races, the researchers identified 59 cases of cardiac arrest, where a runner became unconscious with no pulse during the race or within an hour of finishing. Dr. Baggish admitted that the more recently passed HIPPA laws created new challenges to accessing data for his study. The 59 cases led to 42 deaths from cardiac arrest in distance races, out of 10.9 million, or an incidence rate of one death per 259,52 t runners. Dr. Baggish explained that this rate is comparatively lower than studies reporting deaths in other athletic activities. Most of the incidences concerned marathons rather than half marathons, and 51 of the 59 cases occurred in men.
Kven though the odds are slim of cardiac arrest in distance runs, Dr. Baggish still sounded the warning. "Do not ignore your body" he said. 'If you have been running for years and something suddenly doesn't feel right, you should check it out. There is no one way to describe the feeling of cardiac arrest. It's different in every body and it's not one and done. Some of it has to do with genetics and family history Marly death of a parent is a big red flag."
Awareness is critical. Dr. Baggish stated. This could come in the form of getting information out to runners, much like the hyponatremia scare in 2002. Awareness, Dr. Baggish hopes, will encourage runners to discover their cardiovascular risk profile and discuss it with their physician. Most of the heart attack incidences in his study could be blamed on a preexisting heart problem, something Dr. Baggish said the victims were unaware of.
"It's certainly a human drama issue," Dr. Baggish added. "I talked to next of kin of many of the victims and they said their loved one wouldn't have changed anything they were doing. They loved running."
Since I am one of the "survivors," I mould emphatically concur that bystander CPRfor someone that arrests is the key to survival. That said, J ran 30 marathons in 2010 (then suffered a cardiac arrest at my first marathon in 2011). I was very fortunate that I went down in the marathon that I did [an indoor one]. It was a bystander (fellow runner - a doc) that ran 100 yards to me and performed CPR to save me. Had it occurred in probably 27 of the other 30 marathons that I ran in 2010, I would have been dead due to no one running around me or near me that would have been able to resuscitate me. The good news is that I have recovered and completed another 12 marathons and six halves since.
Greg Gocbel Park Rapids, MN
REFERENCES
Kim JH, MaJhotra R, Chiampasi G, dHemivmirl P, el al. Cinliaeac arrest during long-disumce running raars. N Efigl J Med2012:366:12-40.
Steve Nearman has been a running writer for 30 years and is the event director and fotmder of the Woodroiv Wilson Bridge Half Marathon in Alexandria, Virginia.
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| Author: | Nearman, Steve |
|---|---|
| Publication: | AMAA Journal |
| Geographic Code: | 1USA |
| Date: | Jan 1, 2012 |
| Words: | 1129 |
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