What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Subclinical coronary artery disease (n=105). Intervention: Cardiac CT vs. Conventional preparticipation evaluation. Primary outcome: High coronary atherosclerotic burden.

What question did this study set out to answer?

To evaluate whether standard preparticipation cardiovascular screening and exercise stress testing effectively identify high coronary atherosclerotic burden in asymptomatic veteran male athletes.

November 9, 2018British Journal of Sports Medicine

Subclinical coronary artery disease in veteran athletes: is a new preparticipation methodology required?

Q: What are the key findings of this study?

Conventional screening poorly identified subclinical CAD, as cardiac CT revealed high atherosclerotic burden in 25.7% of veteran athletes, of whom only 6 had abnormal exercise tests.

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Key result

Conventional screening misses subclinical CAD in veteran athletes despite CT showing high atherosclerotic burden in ~26%.

n=105

Why the study?

Does the inclusion of cardiac CT improve the detection of subclinical coronary artery disease compared to conventional preparticipation screening in asymptomatic veteran athletes?

Key Points

To evaluate whether standard preparticipation cardiovascular screening and exercise stress testing effectively identify high coronary atherosclerotic burden in asymptomatic veteran male athletes.
Screened 105 asymptomatic male athletes aged ≥40 years with low-to-moderate cardiovascular risk (Systematic Coronary Risk Estimation <5%) training ≥4 hours/week for at least 5 years.
Conducted clinical risk evaluation, resting electrocardiography, transthoracic echocardiography, and exercise stress testing alongside cardiac CT, including coronary artery calcium scoring and CT angiography.
Cardiac CT detected high coronary atherosclerotic burden in 27 athletes (25.7%), but only 11 of these individuals (40.7%) presented with conventional cardiovascular risk factors.
Exercise testing was abnormal in 13 athletes (12.4%), identifying only 6 of the 27 athletes with high coronary plaque burden, including just 3 positive for myocardial ischaemia.

Study Design

Type

Cross-Sectional (n=105)

Structured PICO

Does the inclusion of cardiac CT improve the detection of subclinical coronary artery disease compared to conventional preparticipation screening in asymptomatic veteran athletes?

Population

105 asymptomatic male athletes aged ≥40 years old, with low to moderate CV risk (Systematic Coronary Risk Estimation <5%) who trained ≥4 hours/week for at least 5 years

Intervention

Cardiac CT (coronary artery calcium score and coronary CT angiography)

Comparator

Conventional preparticipation methodology (clinical evaluation, ECG, transthoracic echocardiogram, and exercise testing)

Outcome

Detection of high coronary atherosclerotic burdensurrogate

Conventional preparticipation screening based on clinical risk factors and exercise testing is poor at identifying significant subclinical CAD in veteran athletes, suggesting a potential role for cardiac CT.

Discussion

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Implication

Conventional screening may miss subclinical CAD in veteran athletes; hypothesis-generating for cardiac CT in preparticipation evaluation.

Cite This Study

Dores et al. (2018) conducted a cross-sectional in Subclinical coronary artery disease (n=105). Cardiac CT vs. Conventional preparticipation evaluation was evaluated on High coronary atherosclerotic burden. Conventional screening poorly identified subclinical CAD, as cardiac CT revealed high atherosclerotic burden in 25.7% of veteran athletes, of whom only 6 had abnormal exercise tests.

synapsesocial.com/papers/6a0ba8ba4f6759c6fca253df https://doi.org/10.1136/bjsports-2018-099840

Topics

Coronary artery disease Coronary CT angiography Sports cardiology

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Subclinical coronary artery disease in veteran athletes: is a new preparticipation methodology required?

Key Points

Study Design

Structured PICO

Discussion

Implication

Cite This Study

Topics

Subclinical coronary artery disease in veteran athletes: is a new preparticipation methodology required?

Key Points

Study Design

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider