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

• Published in: Scandinavian journal of medicine & science in sports 2024-07, Vol.34 (7), p.e14686-n/a
• Main Authors: Hupin, David, Oriol, Mathieu, Laukkanen, Jari A., Abraham, Pierre, Dulac, Nathan, Laugier, Simon, Trauchessec, Guillaume, Carmaux, Antoine, Haber, Benjamain, Bertoletti, Laurent, Costa, Antoine Da, Roche, Frédéric
• Format: Article
• Language: English
• Subjects: Adult; Asymptomatic; asymptomatic adults; Athletes; Atrial Fibrillation - diagnosis; Cardiac arrhythmia; Cardiovascular Diseases - diagnosis; Coronary Angiography; coronary artery disease; CVD prevention; Electrocardiography; exercise ECG; Exercise Test; Female; France - epidemiology; Heart Disease Risk Factors; Humans; Life Sciences; Male; Mass Screening - methods; Middle Aged; Myocardial Ischemia - diagnosis; Myocardial Ischemia - epidemiology; Risk Factors; sports
• ISSN: 0905-7188; 1600-0838; 1600-0838
• DOI: 10.1111/sms.14686

ABSTRACT 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