Morrison, BN, Isserow, S, Taunton, J, Oxborough, D, Moulson, N, Warburton, DER and McKinney, J (2023) Masters athlete screening study (MASS): incidence of cardiovascular disease and major adverse cardiac events and efficacy of screening over five years. European Journal of Preventive Cardiology, 30 (9). pp. 887-899. ISSN 2047-4873

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Abstract

Background The efficacy of cardiovascular screening in Masters athletes (MAs) (≥35 y), and whether screening decreases their risk of major adverse cardiac events (MACEs) is unknown. Purpose To evaluate the effectiveness of yearly cardiovascular screening, and the incidence of cardiovascular disease (CVD) and MACE over five years. Methods and results MAs (≥35 y) without previous history of CVD underwent yearly cardiovascular screening. Participants with an abnormal screen underwent further evaluations. In the initial year, 798 MAs (62.7% male, 55 ± 10 y) were screened; 11.4% (n = 91) were diagnosed with CVD. Coronary artery disease (CAD) was the most common diagnosis (n = 64; 53%). During follow-up, there were an additional 89 CVD diagnoses with an incidence rate of 3.58/100, 4.14/100, 3.74/100, 1.19/100, for years one to four, respectively. The most common diagnoses during follow-up were arrhythmias (n = 33; 37%). Increasing age (OR = 1.047, 95% confidence interval (CI): 1.003–1.094; P = 0.0379), Framingham Risk Score (FRS) (OR = 1.092, 95% CI: 1.031–1.158; P = 0.003), and LDL cholesterol (OR = 1.709, 95% CI: 1.223–2.401; P = 0.002) were predictive of CAD, whereas moderate intensity activity (min/wk) (OR = 0.997, 95% CI: 0.996–0.999; P = 0.002) was protective. Ten MACE (2.8/1000 athlete-years) occurred. All of these MAs were male, and 90% had ≥10% FRS. All underwent further evaluations with only two identified to have obstructive CAD. Conclusion MACE occurred despite yearly screening. All MAs who had an event had an abnormal screen; however, cardiac functional tests failed to detect underlying CAD in most cases. It may be appropriate to offer computed coronary tomography angiography in MAs with ≥10% FRS to overcome the limitations of functional testing, and to assist with lifestyle and treatment modifications.

Item Type:	Article
Additional Information:	This is a pre-copyedited, author-produced version of an article accepted for publication in European Journal of Preventive Cardiology following peer review. The version of record Barbara N Morrison, Saul Isserow, Jack Taunton, David Oxborough, Nathaniel Moulson, Darren E R Warburton, James McKinney, Masters athlete screening study (MASS): incidence of cardiovascular disease and major adverse cardiac events and efficacy of screening over five years, European Journal of Preventive Cardiology, Volume 30, Issue 9, July 2023, Pages 887–899, is available online at: https://doi.org/10.1093/eurjpc/zwad090
Uncontrolled Keywords:	Humans; Cardiovascular Diseases; Coronary Angiography; Prognosis; Incidence; Risk Assessment; Risk Factors; Predictive Value of Tests; Female; Male; Coronary Artery Disease; Athletes; Atrial fibrillation; Cardiovascular risk; Cardiovascular screening; Coronary artery disease; Major adverse cardiac events; Masters athletes; Humans; Male; Female; Cardiovascular Diseases; Incidence; Coronary Angiography; Coronary Artery Disease; Risk Factors; Athletes; Prognosis; Predictive Value of Tests; Risk Assessment
Subjects:	R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine R Medicine > RC Internal medicine > RC1200 Sports Medicine
Divisions:	Sport & Exercise Sciences
Publisher:	Oxford University Press (OUP)
SWORD Depositor:	A Symplectic
Date Deposited:	11 Sep 2023 10:54
Last Modified:	22 Mar 2024 00:50
DOI or ID number:	10.1093/eurjpc/zwad090
URI:	https://researchonline.ljmu.ac.uk/id/eprint/21378

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