Clinical and coronary angiography characteristics of acute myocardial infarction occurring during sport activities: 2011–2017 data from the “obseRvatoire des Infarctus de Côte d’Or” (RICO) survey

Abstract

Coronary artery disease (CAD) is involved in most acute cardiac events occurring during sport activities. We addressed clinical and coronary angiography characteristics of patients with acute myocardial infarction (AMI) during sport activities. From the RICO database, we retrospectively analyzed all the consecutive patients admitted in a university hospital for sport-related AMI and who underwent coronary angiography from 2011 to 2017 ( n = 100). AMI occurred during or within the 1st hour after cycling (41%), jogging (14%), soccer (13%) and other team sports (7%). Median age was 58 (50–67) y, most were male (86%), with body mass index at 25 (24–28) kg/m 2 , a high rate of smoking (37%), hypercholesterolemia (31%), familial or personal history of CAD (29% and 10%, respectively), and diabetes (9%). Strikingly, 30% reported prodromal symptoms. Out-of-hospital (OH) sudden cardiac arrest (SCA) was experienced by 20%; at admission, 11% had Killip > 1 and 54% were STEMI. Most had one-vessel disease (50%) and 14% had no significant stenosis. SYNTAX score was 8 (5–14). More than half (52%) had associated non-significant stenosis. Culprit lesion (87%) was found on LAD or branches (43%) and on RCA (40%), proximal in 47% of patients. One culprit lesion was reported on LM (1%) artery. Thrombus, calcification and ulceration were often found on culprit lesion (53%, 17% and 34% respectively). An occlusion (TIMI 0) was observed in 55% of culprit lesions. Only 5% and 2% had chronic total occlusion and dissection, respectively. Only 26% had lesion length > 20 mm on culprit artery. One patient had an anomalous origin of LM and one had a small coronary fistula. Our works highlight a high rate of risk factors, history of CAD and prodromal symptoms. STEMI counted for 54% of cases and OHSCA occurred in 20% of patients. Their CAD extent was low to moderate, and characterized by a majority of single significant, proximal and short stenosis.