Marathon runners’ cardiac arrest deaths cut in half, new study says

Cardiac-arrest-related deaths during races are rare, but they often in the news, for obvious reasons. Marathoners may face some reassurance by way of a new study, published in JAMA. The research, conducted by Jonathan Kim, a professor at the Emory School of Medicine in Atlanta, Ga., reveals some encouraging new numbers for the running community: despite a significant increase in marathon participation over the past decade, the risk of cardiac arrests during races has remained stable, while survival rates have doubled.

Uncovering the data

Kim’s research, a follow-up to his pioneering 2012 study on cardiac arrests in marathon runners, relied on meticulous data collection. To build their study, Kim and his team had to contact individual race directors, scour media reports and even track down survivors or next of kin. While this approach was time-intensive, it provided a comprehensive look at cardiac events over the past decade.

More than 29 million marathon completions between 2010 and 2023 were scrutinized, highlighting a critical improvement: while cardiac arrest rates have held steady—around 0.60 per 100,000 participants—the likelihood of surviving such an event has significantly improved. Deaths from race-related cardiac arrests have dropped by half compared to the early 2000s.

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The evolution of awareness

The study attributes this remarkable shift to heightened awareness within the running community. Interviews with survivors underscored the importance of immediate medical response, including CPR and access to defibrillators. “What we found was that every one of those people got hands-on cardiopulmonary resuscitation, but the vast majority also had immediate access to an automated external defibrillator,” Kim said. “That’s the difference.” This proactive approach mirrors practices in other public spaces like airports and casinos, where similar decreases in cardiac arrest fatalities have been observed.

Implications for race safety

These findings reinforce the importance of CPR training and strategically placing defibrillators along racecourses. But Kim also stresses the need for better pre-race screening. “These are more often potentially preventable events,” he explains. “Being able to identify people, more commonly older individuals with unrecognized cardiovascular risk factors, doesn’t mean they can’t run a race. Rather, it affords the opportunity to improve primary preventive cardiovascular care and potentially further reduce the risk of cardiac arrest during these events.”

Kim’s research highlights the progress made in protecting marathon runners, but he also emphasizes the need for continued efforts. With millions of people lining up for races each year, better identification of at-risk individuals, expanded CPR education and continued emphasis on race-day medical preparedness could push survival rates even higher.