@article{01GXRJ2PPNJHHGS1PFQ2NF66R9,
  abstract     = {{Aims: The impact of long-term endurance sport participation (on top of a healthy lifestyle) on coronary atherosclerosis and acute cardiac events remains controversial.

Methods and results: The Master@Heart study is a well-balanced prospective observational cohort study. Overall, 191 lifelong master endurance athletes, 191 late-onset athletes (endurance sports initiation after 30 years of age), and 176 healthy non-athletes, all male with a low cardiovascular risk profile, were included. Peak oxygen uptake quantified fitness. The primary endpoint was the prevalence of coronary plaques (calcified, mixed, and non-calcified) on computed tomography coronary angiography. Analyses were corrected for multiple cardiovascular risk factors. The median age was 55 (50-60) years in all groups. Lifelong and late-onset athletes had higher peak oxygen uptake than non-athletes [159 (143-177) vs. 155 (138-169) vs. 122 (108-138) % predicted]. Lifelong endurance sports was associated with having >= 1 coronary plaque [odds ratio (OR) 1.86, 95% confidence interval (CI) 1.17-2.94], >= 1 proximal plaque (OR 1.96, 95% CI 1.24-3.11), >= 1 calcified plaques (OR 1.58, 95% CI 1.01-2.49), >= 1 calcified proximal plaque (OR 2.07, 95% CI 1.28-3.35), >= 1 non-calcified plaque (OR 1.95, 95% CI 1.12-3.40), >= 1 non-calcified proximal plaque (OR 2.80, 95% CI 1.39-5.65), and >= 1 mixed plaque (OR 1.78, 95% CI 1.06-2.99) as compared to a healthy non-athletic lifestyle.

Conclusion: Lifelong endurance sport participation is not associated with a more favourable coronary plaque composition compared to a healthy lifestyle. Lifelong endurance athletes had more coronary plaques, including more non-calcified plaques in proximal segments, than fit and healthy individuals with a similarly low cardiovascular risk profile. Longitudinal research is needed to reconcile these findings with the risk of cardiovascular events at the higher end of the endurance exercise spectrum.}},
  author       = {{De Bosscher, R and Dausin, C and Claus, P and Bogaert, J and Dymarkowski, S and Goetschalckx, K and Ghekiere, O and Van De Heyning, CM and Van Herck, P and Paelinck, B and El Addouli, H and La Gerche, A and Herbots, L and Willems, R and Heidbuchel, H and Claessen, G and Claeys, M and Hespel, P and Dresselaers, T and Miljoen, H and Belmans, A and Favere, Kasper and Vermeulen, D and Witvrouwen, I and Hansen, D and Eijnde, Bert Op't and Thijs, D and Vanvoorden, P and Van Soest, S and Master@Heart, Consortium
}},
  issn         = {{0195-668X}},
  journal      = {{EUROPEAN HEART JOURNAL}},
  keywords     = {{Computed tomography coronary angiography,Coronary artery disease,Exercise,Athlete's heart,ARTERY-DISEASE,CT ANGIOGRAPHY,PHYSICAL-ACTIVITY,PROGNOSTIC VALUE,CARDIORESPIRATORY FITNESS,RISK,CALCIUM,PREVALENCE,PREDICTION,EVENTS}},
  language     = {{eng}},
  number       = {{26}},
  pages        = {{2388--2399}},
  title        = {{Lifelong endurance exercise and its relation with coronary atherosclerosis}},
  url          = {{http://doi.org/10.1093/eurheartj/ehad152}},
  volume       = {{44}},
  year         = {{2023}},
}

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