Kristian Berge, Sylvan L J E Janssen, Birgitta K Velthuis, Peder Langeland Myhre, Arend Mosterd, Torbjørn Omland, Thijs M H Eijsvogels, Vincent L Aengevaeren
{"title":"Predictors of coronary atherosclerosis in middle-aged and older athletes: the MARC-2 study.","authors":"Kristian Berge, Sylvan L J E Janssen, Birgitta K Velthuis, Peder Langeland Myhre, Arend Mosterd, Torbjørn Omland, Thijs M H Eijsvogels, Vincent L Aengevaeren","doi":"10.1093/ehjci/jeae317","DOIUrl":null,"url":null,"abstract":"<p><strong>Aims: </strong>Exercise improves cardiovascular health, but high-volume high-intensity exercise is associated with increased coronary artery atherosclerosis and calcification (CAC). We aimed to identify predictors of CAC in athletes.</p><p><strong>Methods and results: </strong>We assessed the association of traditional and non-traditional cardiovascular risk factors with CAC using linear and logistic regression. 289 male athletes from the MARC-2 study were included, with a median age of 60 [Q1-3 56-66] years, lifelong weekly training load of 26 [17-35] MET-hours, BMI of 24.5 [22.9-26.6] kg/m2, systolic blood pressure of 139±18 mmHg, and reported 0.0 [0.0-8.0] smoking pack years. Thirty-one percent had a CAC score >100 and 13% >400. Among traditional cardiovascular risk factors, higher age, systolic blood pressure, smoking pack years, and family history of coronary artery disease independently predicted greater CAC scores, while body mass index, LDL cholesterol, and diabetes mellitus did not. Among non-traditional risk factors, higher training loads, serum phosphate, and lower adjusted energy intake and fat percentage of energy intake independently predicted greater CAC scores. The full model with all traditional and non-traditional risk factors had higher accuracy in predicting CAC>100 (ROC-AUC 0.76, 95%CI [0.70-0.82]) and CAC>400 (0.85 [0.77-0.92]) than traditional cardiovascular risk factors alone (0.72 [0.65-0.78], p=0.012, and 0.81 [0.74-0.90], p=0.038, respectively).</p><p><strong>Conclusion: </strong>Non-traditional risk factors, including training load, dietary patterns, and serum phosphate, were independently associated with CAC in aging male athletes. Prediction accuracy for CAC increased when including these variables in a prediction model with traditional risk factors.</p>","PeriodicalId":12026,"journal":{"name":"European Heart Journal - Cardiovascular Imaging","volume":" ","pages":""},"PeriodicalIF":6.7000,"publicationDate":"2024-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Heart Journal - Cardiovascular Imaging","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/ehjci/jeae317","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Aims: Exercise improves cardiovascular health, but high-volume high-intensity exercise is associated with increased coronary artery atherosclerosis and calcification (CAC). We aimed to identify predictors of CAC in athletes.
Methods and results: We assessed the association of traditional and non-traditional cardiovascular risk factors with CAC using linear and logistic regression. 289 male athletes from the MARC-2 study were included, with a median age of 60 [Q1-3 56-66] years, lifelong weekly training load of 26 [17-35] MET-hours, BMI of 24.5 [22.9-26.6] kg/m2, systolic blood pressure of 139±18 mmHg, and reported 0.0 [0.0-8.0] smoking pack years. Thirty-one percent had a CAC score >100 and 13% >400. Among traditional cardiovascular risk factors, higher age, systolic blood pressure, smoking pack years, and family history of coronary artery disease independently predicted greater CAC scores, while body mass index, LDL cholesterol, and diabetes mellitus did not. Among non-traditional risk factors, higher training loads, serum phosphate, and lower adjusted energy intake and fat percentage of energy intake independently predicted greater CAC scores. The full model with all traditional and non-traditional risk factors had higher accuracy in predicting CAC>100 (ROC-AUC 0.76, 95%CI [0.70-0.82]) and CAC>400 (0.85 [0.77-0.92]) than traditional cardiovascular risk factors alone (0.72 [0.65-0.78], p=0.012, and 0.81 [0.74-0.90], p=0.038, respectively).
Conclusion: Non-traditional risk factors, including training load, dietary patterns, and serum phosphate, were independently associated with CAC in aging male athletes. Prediction accuracy for CAC increased when including these variables in a prediction model with traditional risk factors.
期刊介绍:
European Heart Journal – Cardiovascular Imaging is a monthly international peer reviewed journal dealing with Cardiovascular Imaging. It is an official publication of the European Association of Cardiovascular Imaging, a branch of the European Society of Cardiology.
The journal aims to publish the highest quality material, both scientific and clinical from all areas of cardiovascular imaging including echocardiography, magnetic resonance, computed tomography, nuclear and invasive imaging. A range of article types will be considered, including original research, reviews, editorials, image focus, letters and recommendation papers from relevant groups of the European Society of Cardiology. In addition it provides a forum for the exchange of information on all aspects of cardiovascular imaging.