Decline in Preventable Cardiac Deaths During Marathons Observed in Recent Research

Recent research indicates a significant decrease in preventable cardiac fatalities during marathons in the United States, despite a rising number of participants in these events. This study, conducted by experts at Emory University, builds on earlier findings regarding unexpected cardiac incidents in long-distance running.

Published in the Journal of the American Medical Association (JAMA), the study reveals that while the overall rate of cardiac arrests among marathon runners has remained stable, the survival rates for those experiencing such events have doubled compared to previous years. Fewer runners are succumbing to cardiac issues during races.

The research team, led by an associate professor from the Emory School of Medicine, undertook this analysis as a follow-up to a 2012 study that was the first of its kind to investigate cardiac arrests in marathon settings. The current findings are especially crucial given the increased popularity of marathon running, which has seen over 29 million participants complete races in the U.S. between 2010 and 2023--a threefold increase compared to the previous decade.

Gathering data for this study posed a challenge, as there is no central registry for race-related cardiac incidents. The research team utilized various resources, including direct outreach to race directors and comprehensive reviews of media reports to compile their findings. Approximately 70% of race directors were contacted, allowing researchers to collect data on event occurrences and participant outcomes.

Through meticulous public searches, the team was able to identify survivors of cardiac arrests and their families, thereby constructing detailed profiles of individual cases. The analysis indicated that while the rate of cardiac arrests stood at 0.60 per 100,000 runners during the recent period, it was nearly identical to the rate of 0.54 per 100,000 noted in the earlier study. However, the mortality rate associated with these cardiac arrests has significantly decreased, dropping from 0.39 per 100,000 to 0.19 per 100,000 participants--indicating a 50% reduction in deaths since the 2000-2009 timeframe.

Findings suggest that cardiac arrests are still more prevalent among male participants and occur more frequently in marathons than in half marathons. The decline in death rates can be attributed to heightened awareness within the sport regarding the risks associated with cardiac events, as well as improved emergency response measures at races.

Insights from interviews with survivors revealed that nearly all received immediate cardiopulmonary resuscitation (CPR), with many also having access to automated external defibrillators (AEDs) during their incidents. This access has proven crucial, as survival rates from cardiac arrests in public venues with AEDs--such as airports--have shown similar improvements.

Experts advocate for continued emphasis on CPR training for race participants and the strategic placement of defibrillators along marathon routes. Furthermore, identifying individuals with potential cardiovascular risks before they participate in races could enhance preventive care and further lower cardiac arrest risks during these events. The study underscores that while the incidence of sudden cardiac arrest remains consistent over the past two decades, addressing underlying health factors may help mitigate these risks in the future.