HealthDay News — Nearby residents appear more likely to die from acute myocardial infarction and cardiac arrest during a marathon, according to research published in the New England Journal of Medicine.

The findings are based on data from Medicare patients (65 years of age and over) in 11 US cities that hosted major marathons between 2002 and 2012.

Of patients taken to the hospital for acute myocardial infarction or cardiac arrest on a marathon day, 28.2% died within a month versus 24.9% of patients admitted in the weeks before or after a marathon (relative risk difference: 13.3%). The investigators found no evidence that the increase was related to cardiovascular issues among marathon participants or out-of-town visitors. There were, however, some ambulance delays. On average, ambulances took an extra 4.4 minutes to get patients to the hospital on marathon days.

“We have traditionally focused medical preparedness and emergency care availability to address the needs of race runners, but our study suggests that effects of a marathon may spread well beyond the course of the event and affect those who live or happen to be nearby,” senior author Anupam B. Jena, MD, PhD, the Ruth L. Newhouse Associate Professor of Health Care Policy at Harvard Medical School in Boston, said in a Harvard news release.

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Jena AB, Mann NC, Wedlund LN, Olenski A. Delays in emergency care and mortality during major US marathons. N Engl J Med. 2017;376:1441-1450. doi: 10.1056/NEJMsa1614073