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.
- Competitive sports eligibility
- Computed Tomography Angiography
- Congenital coronary anomalies
- Coronary Artery Disease
- Coronary artery disease
- Coronary atherosclerosis
- Coronary computed tomography angiography
- Exercise Test
- Mass Screening
- Master athletes
- Middle Aged
- Retrospective Studies
- Risk Assessment