Coronary atherosclerosis in apparently healthy master athletes discovered during pre-PARTECIPATION screening. Role of coronary CT angiography (CCTA)

Michela Cammarano, Riccardo Marano, Vincenzo Palmieri, Salvatore Francesco Gervasi, Laura Palumbo, Giancarlo Savino, Massimiliano Bianco, Paolo Zeppilli, Arianna Di Rocco, Annarita Vestri

Risultato della ricerca: Contributo in rivistaArticolo in rivistapeer review

6 Citazioni (Scopus)

Abstract

Background: Pre-participation screening (PPS) of athletes aged over 35 years (master athletes, MA) is a major concern in Sports Cardiology. In this population, sports-related sudden cardiac death is rare but usually due to coronary atherosclerosis (CA). Coronary CT Angiography (CCTA) has changed the approach to diagnosis/ management of CA, but its role in this context still needs to be assessed. Methods and results: We retrospectively examined 167 MA who underwent CCTA in our hospital since 2006, analyzing symptoms, stress-test ECG, cardiovascular risk profiles (SCORE) and CCTA findings. Among the whole enrolled population, 153 (91.6%) MA underwent CCTA for equivocal/positive stress-test ECG with/without symptoms, 13 (7.8%) just for clinical symptoms, 1 (0.6%) for the family history. The CCTA showed the presence of CA in 69 MA (41.3%), congenital coronary anomalies (anomalous origin or deep myocardial bridge) in 8 (4.8%), both in 7 (4.2%). A negative CCTA was observed in 83 MA (49.7%). The risk-SCORE (age, hypertension, hypercholesterolemia, smoking) was a good indicator for the presence ofmoderate/severe CA on CCTA. However,mild/moderate CAwas present in 17.8% ofMA clinically stratified at a low risk-SCORE. Conclusion:While coronary angiography ismore indicated in athleteswith positive stress-test ECG and high clinical risk, the CCTA may be useful in the evaluation of MAwith an abnormal stress test ECG and/or clinical symptoms engaged in competitive sports with a high cardiovascular involvement. Age, gender, presence of symptoms and clinical risk-SCORE assessment may help sports physicians and cardiologists to decide whether to request a CCTA or not.
Lingua originaleEnglish
pagine (da-a)99-107
Numero di pagine9
RivistaINTERNATIONAL JOURNAL OF CARDIOLOGY
Volume282
DOI
Stato di pubblicazionePubblicato - 2019

Keywords

  • Adult
  • Athletes
  • Competitive sports eligibility
  • Computed Tomography Angiography
  • Congenital coronary anomalies
  • Coronary Artery Disease
  • Coronary artery disease
  • Coronary atherosclerosis
  • Coronary computed tomography angiography
  • Electrocardiography
  • Exercise Test
  • Female
  • Humans
  • Male
  • Mass Screening
  • Master athletes
  • Middle Aged
  • Retrospective Studies
  • Risk Assessment
  • Sports

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