Observational studyEuropean heart journal2023
Lifelong endurance exercise and its relation with coronary atherosclerosis.
Observational study in European heart journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 68 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
68 citing papers in PubMed, 2 syntheses or guidelines pooled it, 118 citations in OpenAlex.
- Coronary Artery Disease in Masters Athletes: A Systematic Review.Sports medicine (Auckland, N.Z.) · 2026Pooled it
- Clinical Considerations for Competitive Sports Participation for Athletes With Cardiovascular Abnormalities: A Scientific Statement From the American Heart Association and American College of Cardiology.Journal of the American College of Cardiology · 2025Guideline
- Carotid atherosclerosis and aortic stiffness in masters athletes: Multimodality vascular phenotyping from the Master@Heart study.American journal of preventive cardiology · 2027Article
- A 9-year longitudinal investigation into physiological aging in highly active older adults.GeroScience · 2026Article
- Resting and exercise-induced occult hypertension and coronary atherosclerosis in male masters endurance athletes.British journal of sports medicine · 2026Article
- Masters Athletes With Abnormal Cardiovascular Findings: A Clinical Consensus Statement of the European Association of Preventive Cardiology of the ESC and the American College of Cardiology.Journal of the American College of Cardiology · 2026Article
- Coronary Artery Disease in Male Athletes-Is Sport Healthy in the Long Run?Journal of clinical medicine · 2026Review
- Exercise-Induced Coronary Remodeling and the Atherosclerotic Paradox in Endurance Athletes: Toward a Unified Mechanobiological Framework.Journal of functional morphology and kinesiology · 2026Review
- Masters athletes with abnormal cardiovascular findings: a clinical consensus statement of the European Association of Preventive Cardiology of the ESC and the American College of Cardiology.European heart journal · 2026Article
- Exercise-specific epigenetic effects on cardiovascular health.Clinical epigenetics · 2026Review
- Observational
- Elucidating the role of SF3B3 in coronary atherosclerosis: integrating bioinformatics and machine learning for advanced insights.Journal of cardiothoracic surgery · 2026Article
- Cardiovascular Imaging Considerations for Masters-Aged Athletes.JACC. Cardiovascular imaging · 2026Review
- Review
- Coronary Atherosclerosis in Master Athletes: Current Knowledge and Future Challenges.Journal of personalized medicine · 2026Review
- Resilience against exercise-related coronary atherosclerosis: A case study in a master athlete participating in 500 marathons.Sports medicine and health science · 2026Article
- Exercise Alleviates Atherosclerosis Through the Modulation of the NLRP3 Inflammasome.Current molecular medicine · 2026Review
- Evidence of early subclinical atherosclerosis in women with exercise-induced hypothalamic amenorrhea.Human reproduction open · 2026Article
- Marathon-associated sudden cardiac death: a mini review of risk perception, pathophysiological mechanisms, and prevention strategies.Frontiers in cardiovascular medicine · 2026Review
- Integrative bioinformatics and machine learning approach unveils potential biomarkers linking coronary atherosclerosis and glutamine metabolism-associated gene.Journal of cardiothoracic surgery · 2025Article
8 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
- Erratum issued
Authors and funding
16 authors at 4 institutions in 2 countries.
Funding
Abstract
aimsThe impact of long-term endurance sport participation (on top of a healthy lifestyle) on coronary atherosclerosis and acute cardiac events remains controversial. METHODS AND
resultsThe Master@Heart study is a well-balanced prospective observational cohort study. Overall, 191 lifelong master endurance athletes, 191 late-onset athletes (endurance sports initiation after 30 years of age), and 176 healthy non-athletes, all male with a low cardiovascular risk profile, were included. Peak oxygen uptake quantified fitness. The primary endpoint was the prevalence of coronary plaques (calcified, mixed, and non-calcified) on computed tomography coronary angiography. Analyses were corrected for multiple cardiovascular risk factors. The median age was 55 (50-60) years in all groups. Lifelong and late-onset athletes had higher peak oxygen uptake than non-athletes [159 (143-177) vs. 155 (138-169) vs. 122 (108-138) % predicted]. Lifelong endurance sports was associated with having ≥1 coronary plaque [odds ratio (OR) 1.86, 95% confidence interval (CI) 1.17-2.94], ≥ 1 proximal plaque (OR 1.96, 95% CI 1.24-3.11), ≥ 1 calcified plaques (OR 1.58, 95% CI 1.01-2.49), ≥ 1 calcified proximal plaque (OR 2.07, 95% CI 1.28-3.35), ≥ 1 non-calcified plaque (OR 1.95, 95% CI 1.12-3.40), ≥ 1 non-calcified proximal plaque (OR 2.80, 95% CI 1.39-5.65), and ≥1 mixed plaque (OR 1.78, 95% CI 1.06-2.99) as compared to a healthy non-athletic lifestyle.
conclusionLifelong endurance sport participation is not associated with a more favourable coronary plaque composition compared to a healthy lifestyle. Lifelong endurance athletes had more coronary plaques, including more non-calcified plaques in proximal segments, than fit and healthy individuals with a similarly low cardiovascular risk profile. Longitudinal research is needed to reconcile these findings with the risk of cardiovascular events at the higher end of the endurance exercise spectrum.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.