Robert S Schwartz1, Stacia Merkel Kraus2, Jonathan G Schwartz3, Kelly K Wickstrom4, Gretchen Peichel5, Ross F Garberich6, John R Lesser7, Stephen N Oesterle8, Thomas Knickelbine9, Kevin M Harris10, Sue Duval11, William O Roberts12, James H O'Keefe13. 1. Robert S. Schwartz, MD, is with the Minneapolis Heart Institute and Foundation at Abbott Northwestern Hospital, Minneapolis, MN. 2. Stacia Merkel Kraus, MPH, is with the Integra Group, Brooklyn Park, MN. 3. Jonathan G. Schwartz, MD, is with the Department of Internal Medicine, University of Colorado Medical Center, Denver, CO. 4. Kelly K. Wickstrom, BS, is with the Minneapolis Heart Institute and Foundation at Abbott Northwestern Hospital, Minneapolis, MN. 5. Gretchen Peichel, RN, is with the Minneapolis Heart Institute and Foundation at Abbott Northwestern Hospital, Minneapolis, MN. 6. Ross F. Garberich, MS, is with the Minneapolis Heart Institute and Foundation at Abbott Northwestern Hospital, Minneapolis, MN. 7. John R. Lesser, MD, is with the Minneapolis Heart Institute and Foundation at Abbott Northwestern Hospital, Minneapolis, MN. 8. Stephen N. Oesterle, MD is with Medtronic Inc., Minneapolis, MN. 9. Thomas Knickelbine, MD, is with the Minneapolis Heart Institute and Foundation at Abbott Northwestern Hospital, Minneapolis, MN. 10. Kevin M. Harris, MD, is with the Minneapolis Heart Institute and Foundation at Abbott Northwestern Hospital, Minneapolis, MN. 11. Sue Duval, PhD, is with the School of Public Health, University of Minnesota, Minneapolis, MN. 12. William O. Roberts, MD, MS, is with the Department of Family Medicine and Community Health, University of Minnesota, St. Paul, MN. 13. James H. O'Keefe, MD, MSMA member since 2003, is with the Saint Luke's Mid America Heart Institute, Kansas City, MO, and the Missouri Medicine Preventive Medicine Editorial Board Member.
Abstract
BACKGROUND: Long-term marathon running improves many cardiovascular risk factors, and is presumed to protect against coronary artery plaque formation. This hypothesis, that long-term marathon running is protective against coronary atherosclerosis, was tested by quantitatively assessing coronary artery plaque using high resolution coronary computed tomographic angiography (CCTA) in veteran marathon runners compared to sedentary control subjects. METHODS: Men in the study completed at least one marathon yearly for 25 consecutive years. All study subjects underwent CCTA, 12-lead electrocardiogram, measurement of blood pressure, heart rate, and lipid panel. A sedentary matched group was derived from a contemporaneous CCTA database of asymptomatic healthy individuals. CCTAs were analyzed using validated plaque characterization software. RESULTS: Male marathon runners (n = 50) as compared with sedentary male controls (n = 23) had increased total plaque volume (200 vs. 126 mm3, p < 0.01), calcified plaque volume (84 vs. 44 mm3, p < 0.0001), and non-calcified plaque volume (116 vs. 82 mm3, p = 0.04). Lesion area and length, number of lesions per subject, and diameter stenosis did not reach statistical significance. CONCLUSION: Long-term male marathon runners may have paradoxically increased coronary artery plaque volume.
BACKGROUND: Long-term marathon running improves many cardiovascular risk factors, and is presumed to protect against coronary artery plaque formation. This hypothesis, that long-term marathon running is protective against coronary atherosclerosis, was tested by quantitatively assessing coronary artery plaque using high resolution coronary computed tomographic angiography (CCTA) in veteran marathon runners compared to sedentary control subjects. METHODS: Men in the study completed at least one marathon yearly for 25 consecutive years. All study subjects underwent CCTA, 12-lead electrocardiogram, measurement of blood pressure, heart rate, and lipid panel. A sedentary matched group was derived from a contemporaneous CCTA database of asymptomatic healthy individuals. CCTAs were analyzed using validated plaque characterization software. RESULTS: Male marathon runners (n = 50) as compared with sedentary male controls (n = 23) had increased total plaque volume (200 vs. 126 mm3, p < 0.01), calcified plaque volume (84 vs. 44 mm3, p < 0.0001), and non-calcified plaque volume (116 vs. 82 mm3, p = 0.04). Lesion area and length, number of lesions per subject, and diameter stenosis did not reach statistical significance. CONCLUSION: Long-term male marathon runners may have paradoxically increased coronary artery plaque volume.
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