title: Prevalence of Subclinical Coronary Artery Disease in Middle-Aged, Male Marathon Runners Detected by Cardiac CT.
abstract: OBJECTIVE
  To evaluate the prevalence of coronary artery disease (CAD) in middle-aged, male marathon runners using coronary dual source CT angiography (DSCTA).
  
  
  METHODS
  50 male marathon runners older than 45 years (mean age: 52.7, standard deviation: 5.9 years, range: 45 to 67 years) received DSCTA including calcium scoring (CS) in addition to standard pre-participation screening. Based on standard risk factors, the risk for coronary events was calculated using the PROCAM score. Coronary status was defined using the following system: 1. absence of CAD (CS zero, no coronary plaques) 2. mild coronary atherosclerosis (CS > 0, coronary plaques with luminal narrowing < 50 %), 3. moderate coronary atherosclerosis (CS > 0, luminal narrowing > 50 %), 4. significant CAD (CS > 0, luminal narrowing > 75 %).
  
  
  RESULTS
  The mean PROCAM score was 1.85 % (standard deviation = 1.56, range 0.39 to 8.47 %). 26/50 marathon runners had no atherosclerosis. 1 of the remaining 24 participants had significant CAD, 3 had moderate coronary atherosclerosis and 20 had mild coronary atherosclerosis. Treadmill exercise testing was unremarkable in terms of myocardial ischemia in all participants. Age, systolic blood pressure, personal minimum time, family history of cardiovascular disease and PROCAM score were factors associated with an increased risk for coronary atherosclerosis.
  
  
  CONCLUSIONS
  Coronary atherosclerosis can be detected in almost 50 % of male marathon runners aged older than 45 years. In 24 % of the participants plaques were located in the proximal coronary system. However, only a minority of these persons have obstructive CAD. As expected, treadmill exercise testing failed to detect these persons that possibly have a higher risk for coronary events.
  
  
  CONCLUSIONS
  • Coronary atherosclerosis can be detected in ~50 % of male marathon runners > 45 years. • Only a minority of these persons have obstructive CAD. • Treadmill exercise testing failed to detect these persons. • Cardiac CT might help to identify athletes with elevated risk for coronary events, especially in persons with a family history of coronary artery.
authors.affiliation: Diagnostic and Interventional Radiology, University Hospital of Tuebingen, Germany.
authors.forename: I
authors.initials: I
authors.lastname: Tsiflikas
authors.affiliation: Diagnostic and Interventional Radiology, University Hospital of Tuebingen, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Thomas
authors.affiliation: Sports Medicine, University Hospital of Tuebingen, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Fallmann
authors.affiliation: Diagnostic and Interventional Radiology, University Hospital of Tuebingen, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Schabel
authors.affiliation: Diagnostic and Interventional Radiology, University Hospital of Tuebingen, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Mangold
authors.affiliation: Diagnostic and Interventional Radiology, University Hospital of Tuebingen, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Ketelsen
authors.affiliation: Diagnostic and Interventional Radiology, University Hospital of Tuebingen, Germany.
authors.forename: C D
authors.initials: CD
authors.lastname: Claussen
authors.affiliation: Center of Dentistry Oral Medicine and Maxillofacial Surgery, University Hospital of Tuebingen, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Axmann
authors.affiliation: Internal Medicine, Klinikum am Eichert, Goeppingen, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Schroeder
authors.affiliation: Center of Dentistry Oral Medicine and Maxillofacial Surgery, University Hospital of Tuebingen, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Burgstahler
mesh_terms: D000368:Aged; D017023:Coronary Angiography / Q000706:statistics & numerical data*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D054526:Men's Health / Q000706:statistics & numerical data; D008875:Middle Aged; D015995:Prevalence; D015203:Reproducibility of Results; D012307:Risk Factors; D012420:Running / Q000706:statistics & numerical data*; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*