Reports of race-related triathlon fatalities have raised questions regarding athlete safety.

To describe death and cardiac arrest among triathlon participants.

Case series.

United States.

Participants in U.S. triathlon races from 1985 to 2016.

Data on deaths and cardiac arrests were assembled from such sources as the U.S. National Registry of Sudden Death in Athletes (which uses news media, Internet searches, LexisNexis archival databases, and news clipping services) and USA Triathlon (USAT) records. Incidence of death or cardiac arrest in USAT-sanctioned races from 2006 to 2016 was calculated.

A total of 135 sudden deaths, resuscitated cardiac arrests, and trauma-related deaths were compiled; mean age of victims was 46.7 ± 12.4 years, and 85% were male. Most sudden deaths and cardiac arrests occurred in the swim segment (n = 90); the others occurred during bicycling (n = 7), running (n = 15), and postrace recovery (n = 8). Fifteen trauma-related deaths occurred during the bike segment. Incidence of death or cardiac arrest among USAT participants (n = 4 776 443) was 1.74 per 100 000 (2.40 in men and 0.74 in women per 100 000; P < 0.001). In men, risk increased substantially with age and was much greater for those aged 60 years and older (18.6 per 100 000 participants). Death or cardiac arrest risk was similar for short, intermediate, and long races (1.61 vs. 1.41 vs. 1.92 per 100 000 participants). At autopsy, 27 of 61 decedents (44%) had clinically relevant cardiovascular abnormalities, most frequently atherosclerotic coronary disease or cardiomyopathy.

Case identification may be incomplete and may underestimate events, particularly in the early study period. In addition, prerace medical history is unknown in most cases.

Deaths and cardiac arrests during the triathlon are not rare; most have occurred in middle-aged and older men. Most sudden deaths in triathletes happened during the swim segment, and clinically silent cardiovascular disease was present in an unexpected proportion of decedents.

Minneapolis Heart Institute Foundation.

与比赛有关的铁人三项死亡报告引发了有关运动员安全的问题。

描述铁人三项参与者的死亡和心脏骤停。

案例系列。

美国。

1985 年至 2016 年美国铁人三项比赛的参赛者。

死亡和心脏骤停的数据来自美国国家运动员猝死登记处（使用新闻媒体、互联网搜索、LexisNexis 档案数据库和新闻剪辑服务）和美国铁人三项 (USAT) 记录。计算了 2006 年至 2016 年 USAT 认可的比赛中死亡或心脏骤停的发生率。

共编制了 135 例猝死、心脏骤停复苏和创伤相关死亡；受害者的平均年龄为 46.7 ± 12.4 岁，85% 为男性。大多数猝死和心脏骤停发生在游泳段（n  = 90）；其他发生在骑自行车（n  = 7）、跑步（n  = 15）和赛后恢复（n  = 8）期间。在自行车环节发生了 15 起与创伤相关的死亡事件。USAT 参与者（n  = 4 776 443）的死亡或心脏骤停发生率为每 10 万人 1.74 人（男性 2.40 人，女性每 10 万人 0.​​74 人；P< 0.001)。在男性中，风险随着年龄的增长而显着增加，并且在 60 岁及以上的人群中风险更大（每 100 000 名参与者中有 18.6 人）。短跑、中跑和长跑的死亡或心脏骤停风险相似（每 100 000 名参与者分别为 1.61 对 1.41 对 1.92）。尸检时，61 名死者中有 27 名（44%）有临床相关的心血管异常，最常见的是动脉粥样硬化性冠状动脉疾病或心肌病。

病例识别可能不完整，并且可能低估事件，特别是在早期研究期间。此外，大多数情况下，赛前病史是未知的。

铁人三项期间的死亡和心脏骤停并不罕见。大多数发生在中年和老年男性身上。大多数铁人三项运动员的猝死发生在游泳阶段，临床上无症状的心血管疾病出现在出乎意料的比例中。

明尼阿波利斯心脏研究所基金会。