Abstract
Regular exercise training is considered healthy as it reduces the risk of cardiovascular events and mortality. Nevertheless, athletes are not immune to the development of cardiovascular diseases and recent studies reported a higher prevalence of coronary artery calcifications and atherosclerotic plaques in athletes compared to less active controls. These observations have raised many questions among sport scientists, sports cardiologists, amateur athletes, and the general population. For example, Are athletes (not) immune for coronary atherosclerosis? How to assess coronary atherosclerosis in athletes? What about chalk (calcified plaque) and cheese (mixed plaque)? Does exercise intensity play a role? Are there sport‐related differences? Are there sex differences? Can sports medical evaluation detect coronary atherosclerosis? Do athletes get worried? Should athletes get worried? How should athletes with coronary atherosclerosis be managed? The goal of this review is to discuss the latest scientific insights and to answer these important questions. Furthermore, we will explore potential clinical implications and point out directions for further research.
Highlights
15 minutes of physical activity per day is associated with a 14% reduction in all-cause mortality.[4]
The most active individuals were more likely to have a CAC score (CACS) >100 (ORadjusted: 1.11; 95% CI: 1.03-1.20) compared with individuals performing less physical activity
Braber et al previously showed that among 318 middle-aged male amateur athletes who underwent a sports medical evaluation without abnormalities, as much as 19% had a CACS ≥100 and/or ≥50% stenosis[29] (Figure 2). These findings suggest that a substantial proportion of asymptomatic athletes can have subclinical atherosclerosis that goes undetected during sports medical evaluations and may place them at risk of cardiac events
Summary
The following full text is a publisher's version. For additional information about this publication click this link. Please be advised that this information was generated on 2021-11-08 and may be subject to change. Coronary atherosclerosis in middle-aged athletes: Current insights, burning questions, and future perspectives. Funding information Dutch Heart Foundation, Grant/Award Numbers: #2017T088, #2017T051
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