title: Relation between playing position and coronary artery calcium scores in retired National Football League players.
abstract: Retired National Football League (NFL) linemen have an increased prevalence of risk factors for atherosclerosis and have an increased risk of cardiovascular death compared with nonlinemen and the general population. We evaluated whether playing in lineman position is independently associated with an increased risk of the presence and severity of subclinical atherosclerosis. Players were categorized as linemen if they reported playing on the offensive or defensive line during their careers. Subclinical atherosclerosis was assessed using coronary artery calcium (CAC) scores in 931 retired NFL players (310 linemen, 621 nonlinemen). CAC scores were evaluated for absence of subclinical atherosclerosis (CAC = 0), presence of mild subclinical atherosclerosis (CAC 1 to 100), and moderate to severe subclinical atherosclerosis (CAC ≥100). We performed multivariate logistic regression to determine whether the lineman position is independently associated with the presence and severity of subclinical atherosclerosis. Linemen were noted to have a lesser likelihood of absence of subclinical atherosclerosis (CAC = 0, 33.8% vs 41.7%, p = 0.02), a similar likelihood of mild subclinical atherosclerosis (CAC 1 to 100, 33.2% vs 31.8%, p = 0.7), and a greater likelihood of moderate to severe subclinical atherosclerosis (CAC >100, 32.9% vs 26.4%, p = 0.04) compared with nonlinemen. Adjusting for demographic and metabolic covariates, lineman status remained independently associated with mild subclinical atherosclerosis (CAC 1 to 100, odds ratio [OR] 1.41, 95% confidence interval [CI] 1.05 to 2.2, p = 0.04) and moderate to severe subclinical atherosclerosis (CAC ≥100, OR 1.67, 95% CI 1.05 to 2.2). The association was attenuated after adjustment for race (CAC 1 to 100, OR 1.24, 95% CI 0.82 to 1.8; CAC >100, OR 1.59, 95% CI 1.01 to 2.49). In conclusion, lineman status in retired NFL players is associated with presence and severity of subclinical atherosclerosis, which is partly explained by race.
authors.affiliation: Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, Texas. Electronic address: basra@bcm.edu.
authors.forename: Sukhdeep Singh
authors.initials: SS
authors.lastname: Basra
authors.affiliation: Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, Texas; Methodist DeBakey Heart and Vascular Center, Houston, Texas.
authors.forename: Yashashwi
authors.initials: Y
authors.lastname: Pokharel
authors.affiliation: Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, Texas.
authors.forename: Ravi S
authors.initials: RS
authors.lastname: Hira
authors.affiliation: Texas Heart Institute, Houston, Texas.
authors.forename: Salman J
authors.initials: SJ
authors.lastname: Bandeali
authors.affiliation: Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, Texas; Methodist DeBakey Heart and Vascular Center, Houston, Texas; Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas.
authors.forename: Vijay
authors.initials: V
authors.lastname: Nambi
authors.affiliation: Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, Texas; Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas.
authors.forename: Anita
authors.initials: A
authors.lastname: Deswal
authors.affiliation: Baptist Health South Florida, Miami, Florida.
authors.forename: Khurram
authors.initials: K
authors.lastname: Nasir
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Seth S
authors.initials: SS
authors.lastname: Martin
authors.affiliation: University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Vogel
authors.affiliation: Living Heart Foundation, Little Silver, New Jersey.
authors.forename: Arthur J
authors.initials: AJ
authors.lastname: Roberts
authors.affiliation: Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, Texas; Methodist DeBakey Heart and Vascular Center, Houston, Texas.
authors.forename: Christie M
authors.initials: CM
authors.lastname: Ballantyne
authors.affiliation: Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, Texas; Methodist DeBakey Heart and Vascular Center, Houston, Texas; Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas; Health Policy, Quality and Informatics Program, Health Services Research and Development Center for Innovations, Michael E. DeBakey Veteran Affairs Medical Center, Houston, Texas.
authors.forename: Salim S
authors.initials: SS
authors.lastname: Virani
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D002114:Calcinosis / Q000175:diagnosis* / Q000453:epidemiology / Q000378:metabolism; D002118:Calcium / Q000378:metabolism*; D003331:Coronary Vessels / Q000378:metabolism*; D005538:Football; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012720:Severity of Illness Index; D014481:United States / Q000453:epidemiology
chemical_list: D002097:C-Reactive Protein; D002118:Calcium