Screening Sportsmen and Sportswomen Over Age 35: The Relevance of an Exercise Electrocardiogram. Data From the SEEPRED Study.

Autor: Hupin D; Univ Jean Monnet, Department of Clinical and Exercise Physiology, University Hospital of Saint-Etienne, Mines Saint-Étienne, INSERM U 1059, Saint-Étienne, France., Oriol M; Support and Education Technic Centre of Health Examination Centres, CETAF, Saint-Etienne, France., Laukkanen JA; Institute of Public Health and Clinical Nutrition and Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.; Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland., Abraham P; IMITOVASC Institute, UMR CNRS 6015 UMR INSERM 1083, University of Angers, Angers, France.; Sports and Exercise Medicine and Vascular Medicine, University Hospital, Angers, France., Dulac N; Faculty of Medicine, UJM-Saint-Etienne, Saint-Etienne, France., Laugier S; Faculty of Medicine, UJM-Saint-Etienne, Saint-Etienne, France., Trauchessec G; Faculty of Medicine, UJM-Saint-Etienne, Saint-Etienne, France., Carmaux A; Univ Jean Monnet, Department of Cardiology, University Hospital of Saint-Etienne, Mines Saint-Étienne, INSERM U 1059, Saint-Étienne, France., Haber B; Univ Jean Monnet, Department of Cardiology, University Hospital of Saint-Etienne, Mines Saint-Étienne, INSERM U 1059, Saint-Étienne, France., Bertoletti L; Univ Jean Monnet, Department of Vascular and Therapeutic Medicine, University Hospital of Saint-Etienne, Mines Saint-Étienne, INSERM U 1059, Saint-Étienne, France., Costa AD; Univ Jean Monnet, Department of Cardiology, University Hospital of Saint-Etienne, Mines Saint-Étienne, INSERM U 1059, Saint-Étienne, France., Roche F; Univ Jean Monnet, Department of Clinical and Exercise Physiology, University Hospital of Saint-Etienne, Mines Saint-Étienne, INSERM U 1059, Saint-Étienne, France.
Jazyk: angličtina
Zdroj: Scandinavian journal of medicine & science in sports [Scand J Med Sci Sports] 2024 Jul; Vol. 34 (7), pp. e14686.
DOI: 10.1111/sms.14686
Abstrakt: Introduction: The importance of exercise electrocardiogram (ECG) is still controversial in the prevention of cardiovascular events among sportsmen and sportswomen. The aim of this study was to assess the relevance of exercise ECG as a screening tool to prevent cardiovascular events when any cardiovascular disease (CVD) risk factors are present.
Methods: The study included leisure time asymptomatic sportsmen and sportswomen over age 35 evaluated from 2011 to 2016 at the University Hospital of Saint-Etienne (France). Major adverse cardiovascular events (MACE) and atrial fibrillation were collected at 3 years.
Results: Of the cohort of 2457 sportsmen and sportswomen (mean age 50.2 ± 9.4 years), 50 (2%) had a high-risk SCORE2. A total of 256 exercise ECGs (10%) were defined as positive, most of them due to silent myocardial ischemia (SMI) (n = 196; 8%). These 196 SMI cases led to 33 coronary angiograms (1%), which revealed 23 significant coronary stenoses requiring revascularization. In multivariate logistic regression analysis, having at least two CVD risk factors was independently associated with (1) positive exercise ECG (OR = 1.80 [95% CI: 1.29-2.52], p = 0.0006), with (2) suspected SMI (OR = 2.57 [95% CI: 1.10-6.02], p = 0.0304), with (3) confirmed SMI (OR = 8.20 [95% CI: 3.46-19.46], p < 0.0001) and with (4) cardiovascular events (MACE or atrial fibrillation) (OR = 6.95 [95% CI: 3.49-13.81], p < 0.0001) at 3 years (median).
Conclusions: The study supports the European recommendations for the use of exercise ECG in evaluation of asymptomatic leisure time sportsmen over age 35. Having at least two CVD risk factors was the best predictor for presence of coronary artery stenosis that may increase the risk for adverse events.
Trial Registration: ClinicalTrials.gov Identifier: NCT06024863.
(© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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