Objective: To determine whether there is a "dose-dependent" relationship between coronary atherosclerosis and the burden of exercise.
Background: Recent data have suggested there may be negative consequences related to strenuous exercise. Previous studies evaluating the presence of coronary atherosclerosis as assessed by coronary calcium scores have been confounded by the presence of other cardiovascular risk factors. We aimed to assess whether there was a relationship between the burden of coronary calcium and the amount of running in a local cohort.
Patients And Methods: Eighty-five runners were screened on the basis of an exercise questionnaire that was later used to determine the experimental groups from January 2016 through October 2016. Twenty-nine individuals were excluded from the study because of the presence of preexisting cardiovascular risk factors. Runners were divided into 3 categories: Group A comprised runners who had competed in at least 10 ultramarathons and/or Ironman competitions in 10 years. Group B included runners who had participated in more than 9 marathons over 10 years. Group C comprised runners who had competed in more than 9 shorter races over 10 years. Coronary artery calcium (CAC) scores were assessed by computed tomography. Statistical analysis was performed using chi-square analyses. Logistic regression models were used to assess the relationship between runner groups and calcium score greater than 100, calcium score percentile, and calcium score greater than 0.
Results: There were no differences between groups A and B for CAC scores greater than 0 or greater than 100, and a similar percentage of group A and B athletes had scores greater than the 50th percentile. Groups A and B were combined for further analysis. Among those runners participating in extreme distance running (groups A and B), 73% of runners had CAC scores greater than 0 whereas only 21% of group C runners had CAC scores greater than 0 (=.0002). Moreover, 70% of group A + B athletes ranked above the 50th percentile of their age and sex as assessed by a national database (Hoff JA, Chomka EV, Krainik AJ, Daviglus M, Rich S, Kondos GT. Age and gender distributions of coronary artery calcium detected by electron beam tomography in 35,246 adults. . 2001;87(12):1335-1339), whereas only 19% of group C runners were ranked above the 50th percentile (=.0001). One-third of runners in group A + B had CAC scores greater than 100 as compared with only 12% of runners in group C (=.05). When controlling for age, sex, and number of years running, the study group was not a significant predictor of CAC greater than 100 (=.12). In contrast, group A + B was 10 times more likely than group C to have CAC scores in the 50th percentile or greater (=.02) and 8.8 times more likely to have a abnormal calcium score when controlling for covariates (=.03).
Conclusion: A significantly higher rate of coronary artery calcification existed in long-term marathon, ultramarathon, and extreme runners than in submarathon runners. Marathoners and ultramarathoners also had a higher incidence of calcification, as well as higher average plaque burden, as compared to a standard database. Marathoners and ultramarathoners also had above-average coronary calcium scores as compared to a national database.
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http://dx.doi.org/10.1016/j.mayocpiqo.2019.03.009 | DOI Listing |
Circ J
January 2025
Division of Pulmonary Medicine, Department of Internal Medicine, Keio University School of Medicine.
Background: Coronary artery calcification (CAC) detected through chest computed tomography (CT) strongly predicts cardiovascular events in asymptomatic individuals undergoing primary prevention. Few studies with limited sample sizes have investigated the predictive value of CAC for cardiovascular complications in COVID-19. This study examined the impact of CAC on cardiovascular complications using a large-scale COVID-19 database.
View Article and Find Full Text PDFEur J Prev Cardiol
January 2025
Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Introduction: Premature advanced subclinical coronary atherosclerosis among young adults is an under-recognized and unique disease phenotype that has not been well characterized.
Methods: We used data from 44,047 participants with no prior CVD history (59.8% male) from the Coronary Artery Calcium (CAC) Consortium.
Eur Heart J Cardiovasc Imaging
January 2025
Departments of Medicine (Division of Artificial Intelligence in Medicine), Biomedical Sciences and Imaging, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Aims: Proximal coronary artery calcium (CAC) may improve prediction of major adverse cardiac events (MACE) beyond the CAC score, particularly in patients with low CAC burden. We investigated whether the proximal CAC can be detected on gated cardiac computer tomography (CT) and whether it provides prognostic significance with artificial intelligence (AI).
Methods And Results: A total of 2016 asymptomatic adults with baseline CAC CT scans from a single site were followed up for MACE for 14 years.
Diabetol Metab Syndr
January 2025
Department of Radiology, Shanghai Health and Medical Center, No. 67 Dajishan, Binhu District, Wuxi, 214065, China.
Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is characterized by the presence of at least one cardiovascular disease (CVD) risk factor, underscoring its potential to elevate CVD risk in affected individuals. However, evidence linking MASLD to subclinical coronary atherosclerosis remains scarce, and further investigations are necessary to elucidate the independent role of varying MASLD severities as a CVD risk factor.
Methods: This study analyzed 7,507 participants aged ≥ 40 who underwent comprehensive health evaluations at the Shanghai Health and Medical Center.
Nutr Metab Cardiovasc Dis
December 2024
Department of Radiology, Innsbruck Medical University, Innsbruck, Austria. Electronic address:
Background And Aims: The interaction of serum uric acid (SUA) with atherogenesis is incompletely understood. Aim of our study was to investigate the association of SUA levels with coronary plaque composition including high-risk-plaque (HRP) features by coronary computed tomography angiography (CTA) and for the prediction of major adverse cardiac events (MACE).
Methods And Results: 1242 patients (age 66.
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