Masters Athlete Screening Study: Four-Year Cardiovascular Disease and Event Incidence

Abstract

BACKGROUND: Masters athletes (≥35 yrs) are not immune to elevated cardiovascular risk and cardiac events. In the first year of Masters Athlete Screening Study, 798 masters athletes were screened; 91 (11.4%) of the cohort were found to have cardiovascular disease (CVD). Coronary artery disease (CAD) was the most common diagnosis (7.9%). PURPOSE: To evaluate the incidence of CVD and adverse cardiovascular events over four years of the screening study. METHODS: Masters athletes (≥35yrs) from a variety of sports without previous history of CAD underwent yearly cardiovascular screening for four years. The screen consisted of anthropometrics, resting blood pressure, resting electrocardiogram, modified American Heart Association 14-element recommendations, cardiovascular event questionnaire, physical examination (year one), and Framingham Risk Score. Participants with an abnormal screen according to the European Association of Cardiovascular Prevention and Canadian Cardiology Society Guidelines underwent further evaluations. RESULTS: During the following three years of study an additional 45 cases of CVD were detected, with an incidence rate of 1.9/100 (64.7±7.3yr; 79%M), 3.0/100 (65.1±7.3yr; 62%M), and 1.5/100 (65.0±5.8yr; 80%M), for years two, three, and four, respectively. Twelve participants had a new CVD diagnoses or progression of a diagnoses. The most common diagnoses over the three years was CAD (n=15; 33.3%) and atrial arrhythmias (n=14; 31.1%). An additional 9 participants were diagnosed CVD outside of the study (atrial fibrillation n=2; moderate CAD n=2; mild CAD n=4; genotype positive hypertrophic cardiomyopathy n=1). Five out of 798 (0.6%) participants had a myocardial infarction. A single CV death occurred. Three of the individuals who had a cardiac event demonstrated a negative exercise treadmill test (ETT) (mean time 15±2.9 min) and three had a positive ETT (mean time 12±1.2 min); two of which initiated cholesterol-lowering medication after confirmation of CAD via CCTA, and one declined medication after a negative MIBI. CONCLUSION: Yearly cardiovascular screening of masters athletes identified ~2 new diagnoses per 100 athletes per year (primarily CAD and atrial fibrillation). Despite yearly cardiovascular screening and high fitness, myocardial infarctions still occur.