ReviewFrontiers in cardiovascular medicine2026
Marathon-associated sudden cardiac death: a mini review of risk perception, pathophysiological mechanisms, and prevention strategies.
Review in Frontiers in cardiovascular medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Marathon running is widely promoted for its cardiovascular and overall health benefits, yet rare cases of sudden cardiac death (SCD) during long-distance races continue to raise substantial clinical and public health concerns. Although the absolute incidence of marathon-associated SCD is low, its catastrophic nature necessitates a clearer understanding of risk perception, epidemiological patterns, pathophysiological mechanisms, and preventive strategies. This mini review synthesizes current evidence on the incidence, demographic characteristics, etiological spectrum, and temporal features of cardiac arrest and SCD during marathon running. Available data indicate that risk is higher in men, older runners, and full-marathon participants, with most events occurring in the final phase of the race or shortly after finishing. Coronary artery disease remains the predominant cause in middle-aged and older runners, whereas inherited cardiomyopathies, congenital coronary anomalies, and myocarditis are more relevant in younger athletes. We further discuss the mechanistic basis of exercise-triggered fatal events, including acute ischemia, malignant ventricular arrhythmias, myocardial fibrosis, and inflammatory myocardial injury. Current preventive approaches, including pre-participation cardiovascular screening, electrocardiography, advanced imaging, genetic evaluation in selected individuals, and rapid on-site resuscitation systems, have improved event recognition and survival outcomes, but important controversies persist regarding optimal screening intensity, interpretation of subclinical findings, and the dose-response relationship between extreme endurance exercise and cardiovascular risk. Future efforts should prioritize precision risk stratification, longitudinal evaluation of subclinical cardiovascular abnormalities, integration of wearable monitoring technologies, and standardized race-day emergency preparedness to improve the safety of long-distance running.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.