Thijs Braber MD, Presenter: Nothing to Disclose

Arend Mosterd MD, PhD, Abstract Co-Author: Nothing to Disclose

Niek Prakken MD, PhD, Abstract Co-Author: Nothing to Disclose

Pieter Doevendans, Abstract Co-Author: Nothing to Disclose

Willem P. Mali MD, PhD, Abstract Co-Author: Nothing to Disclose

Hendrik M. Nathoe MD, PhD, Abstract Co-Author: Nothing to Disclose

Michiel Bots MD, PhD, Abstract Co-Author: Nothing to Disclose

Birgitta Katinka Velthuis MD, Abstract Co-Author: Research Consultant, Koninklijke Philips NV Speakers Bureau, Koninklijke Philips NV

Over 90% of exercise related cardiac arrests occur in men aged 45 years or older, in whom coronary artery disease (CAD) is the main cause. The current cardiovascular evaluation of middle-aged recreational athletes essentially consists of a medical history, physical examination, resting and exercise electrocardiography. Coronary computed tomography angiography (CCTA) provides a minimally invasive, low radiation dose opportunity to image the coronary arteries. We aim to assess the feasibility and added value of CCTA in asymptomatic male recreational athletes aged ≥ 45 years who underwent a sports medical evaluation.

320 participants underwent prospective ECG-triggered CCTA using a 256-slice CT scanner. After exclusion of 44 participants with diabetes, hypertension, or an ESC risk score > 4% a group of 276 men with a low SCORE risk (0-4%) remained in whom the presence of CAD was defined as a Coronary Artery Calcium Score (CACS) ≥ 100 Agatston Units or ≥ 50% luminal stenosis.

In 41 (15%, 95% CI 10.8 – 19.1) of 276 participants with a low ESC SCORE risk and good exercise tolerance (see table), relevant CAD (CACS ≥100 or luminal stenosis ≥50%) was found. The number needed to screen was 6.7.

Minimally invasive CCTA is feasible and detects relevant coronary artery disease in 15% of asymptomatic male athletes ≥45 years with a low ESC SCORE risk and normal exercise testing.

Minimally-invasive CCTA can play a role in identifying older athletes at increased risk of cardiovascular events and can be of great value in the prevention of exercise related CV events.

Braber, T, Mosterd, A, Prakken, N, Doevendans, P, Mali, W, Nathoe, H, Bots, M, Velthuis, B, Coronary Artery Disease in Asymptomatic Male Athletes Aged 45 years or Older with a Low ESC SCORE Risk: The Emerging Role of Coronary CT Angiography.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14045772.html