Heart attack deaths during marathons have dropped significantly in recent years, despite a rise in marathon participation, according to a new study by Jonathan Kim, associate professor at Emory School of Medicine. This research is a follow-up to his 2012 study on unexpected cardiac arrests during marathons.
The new study, published in JAMA, shows that while the rate of cardiac arrests among marathon runners has remained steady, the survival rate has doubled. Fewer runners who suffer a cardiac arrest are dying from it now.
Between 2010 and 2023, more than 29 million people ran marathons in the U.S., tripling the number from the previous decade, which Kim analyzed in his earlier study. Since there is no central registry for race-related cardiac events, Kim’s team relied on various sources, including race directors.
“We used several sources, including media reports, and contacted about 70% of race directors who helped us gather event data,” Kim explains.
The researchers also reached out to survivors of cardiac arrests and their families to build detailed profiles of the cases. “Most cases were found through public search engines, including all of the deaths,” Kim adds.
The study found that while the rate of cardiac arrests was nearly identical across both study periods (.60 per 100,000 participants now versus .54 per 100,000 previously), the death rate from these arrests halved – dropping from .39 per 100,000 to .19 per 100,000. This represents a 50% decline in deaths from 2000 to 2009. Cardiac arrests were still more common among men and in marathons compared to half marathons.
The improvement in survival rates can be attributed to the sport’s increasing awareness of cardiac arrest risks. Kim believes that having immediate access to emergency services, including CPR and defibrillators, has been key. “Every survivor received CPR, and most had access to an automated external defibrillator,” he says.
This survival rate mirrors those seen in public places like airports and casinos, where defibrillators are commonly available, leading to similar declines in deaths.
Kim suggests that these findings highlight the importance of CPR training for race participants and placing defibrillators along race courses. He also emphasizes the need to identify vulnerable individuals, especially older participants with undiagnosed cardiovascular risks.
“These events are often preventable,” Kim notes. “Identifying at-risk runners offers a chance to improve preventive care and reduce the risk of cardiac arrest during races.” The incidence of sudden cardiac arrest in marathons has remained steady for over two decades, making it a key area for future research.
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