SPC365

Coronary atherosclerotic burden in master athletes: relationship with cardiovascular risk and volume of exercise

Session: Sessão Melhores Comunicações Orais
Speaker: Joana Certo Pereira

Congress: CPC 2024
Topic: P. Other
Theme: 37. Miscellanea
Subtheme: 29.3 Sports Cardiology
Session Type: Comunicações Orais
FP Number: ---
Authors: Joana Certo Pereira; Rita Reis Santos; Francisco Moscoso Costa; José Monge; Pedro de Araújo Gonçalves; Hélder Dores
<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:11.0pt">Background:</span></strong><span style="font-size:11.0pt"> Although prior studies suggesting an association between coronary artery calcification (CAC) and lifelong exercise, the clinical relevance and mechanisms for this interaction remains unknown. Recent evidence suggests that a significant amount of exercise might not be linked to a more favourable composition of coronary plaques</span><span style="font-size:11.0pt">. </span><span style="font-size:11.0pt">We aimed to analyse the prevalence of high coronary atherosclerotic (CAS) burden assessed by coronary CT scan (CCTA) in master athletes, according to cardiovascular (CV) risk and volume of exercise.</span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:11.0pt">Methods: </span></strong><span style="font-size:11.0pt">A total of 105 master male athletes (48</span><span style="font-size:11.0pt"><span style="font-family:Symbol">&plusmn;</span></span><span style="font-size:11.0pt">5.6 years old), asymptomatic and without known CV disease, were prospectively studied. A high CAS burden was defined as the presence of at least one of the following characteristics in CCTA: CAC score &gt;100; CAC score &gt;75th percentile; obstructive plaques; plaques in the left main, three vessels or two vessels including the proximal anterior descending artery; segment Involvement Score (SIS) &gt;5; CT-adapted Leaman score (CT-LeSc) &ge;5. <span style="color:black">This variable was evaluated according to the CV risk, stratified by SCORE2, and volume of exercise, determined by metabolic equivalent task score (MET/hour/week).</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:11.0pt">Results: </span></strong><span style="font-size:11.0pt">Most athletes (n=88) were engaged in endurance sports, during 17.1</span><span style="font-size:11.0pt"><span style="font-family:Symbol">&plusmn;</span></span><span style="font-size:11.0pt">9.8 years, with a median exercise volume of 66 </span><span style="font-size:11.0pt"><span style="font-family:Symbol">[</span></span><span style="font-size:11.0pt">IQR 44-103</span><span style="font-size:11.0pt"><span style="font-family:Symbol">]</span></span><span style="font-size:11.0pt"> METs/hour/week. The mean SCORE2 was 2.8&plusmn;1.5%, with 76.9% of athletes classified as having a low to moderate CV risk, and none having very high-risk. A high CAS burden was present in 25.7% of the athletes, without significant differences according to the SCORE2 risk categories [Low-Moderate <em>Vs.</em> High Risk: 25.5% <em>Vs.</em> 37.5%, respectively ; p=0.142] nor volume of exercise [below <em>Vs.</em> above median: 30.6% <em>Vs.</em> 21.4%, respectively; p=0.283)] (Figure 1 A). Combining these variables, athletes with high CV risk and a high volume of exercise showed significantly higher occurrence of a high CAS burden compared to those with low-moderate risk and high volume of exercise (50% <em>Vs.</em> 15.6%; p=0.017). Among athletes with low-moderate risk, high volume of exercise trended to be protective (15.6% <em>Vs.</em> 31.4%; p=0,092), while there was a similar rate of high CAS burden in athletes with low volume of exercise, independently of risk class (Figure 1B). </span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:11.0pt">Conclusions: </span></strong><span style="font-size:11.0pt">In our cohort of master athletes, one fourth demonstrated a high burden of CAS burden evaluated by CCTA. While a higher volume of exercise combined with high cardiovascular risk showed an association with worse coronary composition it trended to be protective in athletes with lower risk. Integrating clinical and exercise-related data is crucial for evaluating athletes amidst the complex associations between exercise, cardiovascular risk, and CAS burden, necessitating longitudinal studies for comprehensive understanding.</span></span></span></p>