Fewer long-distance runners are dying from heart problems during organized races, according to a new study published in JAMA.
Between 2010 and 2023, more than 29 million runners completed marathons and half-marathons in the US, nearly three times more than the previous decade, said George Chiampas, DO, assistant professor of Emergency Medicine and of Orthopaedic Surgery, and a co-author of the study.
“Sudden cardiac arrest is still a leading cause of death in the United States,” said Chiampas, who serves as chief medical officer of Bank of America races, including the Chicago Marathon. “When these incidents occur in running events, unfortunately that becomes the story. Our race directors asked a question: how can we improve outcomes when these events occur?”
In the study, Chiampas and his collaborators aimed to understand the outcomes of cardiac arrests during these races by reviewing race finishers’ records and conducting comprehensive case reviews from media reports, race directors, USA Track & Field claims, and interviews with survivors or next of kin.
The study found that among the 29 million race finishers, there were 176 cardiac arrests, with men more likely to be affected than women. The number of cardiac arrests remained unchanged compared to the previous decade, at approximately 0.54 per 100,000 participants. However, the incidence of cardiac deaths dropped significantly from 0.39 per 100,000 to 0.20 per 100,000 participants, and the fatality rate decreased from 71 percent to 34 percent.
Cardiac arrests were more common during marathons than half-marathons, according to the findings, and coronary artery disease was identified as the most common cause of cardiac arrest among runners with sufficient data available.
The study also highlighted that timely CPR – or cardiopulmonary resuscitation – was linked with a higher chance of survival.
Chiampas said the study vindicates the various strategies he and his collaborators have implemented at Chicago area races, which include strategic placement of AEDs – automated external defibrillators – and providing CPR training to race staff.
“By having all race participants and volunteers review an instructional CPR video and by placing multiple AED’s along the racecourse, we’re able to double survival and educate individuals not only for race day, but for the rest of their lives,” Chiampas said.
Building off his latest study, Chiampas said he will continue working to bring CPR and AED use education to the wider public.
“We are looking to try to drive greater education and videos across the state of Illinois, advocating for AEDs across our communities, and making sure that we are bringing education to higher-risk communities, so they understand that they are a bridge until an ambulance arrives,” Chiampas said.
The study was supported by National Heart, Lung, and Blood Institute grant R01HL162712.
