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. 2019 May 27;3(2):122-130.
doi: 10.1016/j.mayocpiqo.2019.04.004. eCollection 2019 Jun.

Cardiorespiratory Fitness and Coronary Artery Calcification in a Primary Prevention Population

Cindy A Kermott  1 , Darrell R Schroeder  2 , Stephen L Kopecky  3 , Thomas R Behrenbeck  3   4
Affiliations

Cardiorespiratory Fitness and Coronary Artery Calcification in a Primary Prevention Population

Cindy A Kermott et al. Mayo Clin Proc Innov Qual Outcomes. .

Abstract

Objective: To elucidate whether cardiorespiratory fitness (CRF) is protective or contributory to coronary artery disease plaque burden.

Patients and methods: Study participants were working middle-aged men from the Mayo Clinic Executive Health Program who underwent coronary artery calcium (CAC) assessment and exercise treadmill testing for risk stratification. Data from January 1, 1995, through December 31, 2008, were considered. The CAC assessment score was used for lifelong plaque burden analysis; functional aerobic capacity (FAC) from treadmill testing was analyzed as 4 ranked categories of CRF. Known risk factors for cardiovascular disease, including family history, were also considered.

Results: In 2946 male patients in this retrospective, cross-sectional, observational study, known cardiovascular risk factor profiles and risk calculations tended to uniformly improve with increasing CRF, defined by the FAC level. Only the above-average group, or the third of 4 levels, was found consistently lower than other levels of FAC for CAC scores. The above-average group also had statistical significance after controlling for age, body mass index, and family history of coronary artery disease in a U-shaped distribution rather than the expected linear dose-response relationship. Plaque burden was significantly increased in patients with the highest FAC level (P=.005) compared with the above-average group despite the observed maximal risk factor optimization in all known conventional cardiovascular risk factors.

Conclusion: For men, maximal CRF is associated with increased atherosclerosis, established with CAC scores. By comparison, average-to-moderate CRF appears to be cardioprotective regardless of either age or the influence of other contributing, recognized cardiac risk factors.

Keywords: BMI, body mass index; CAC, coronary artery calcium; CAD, coronary artery disease; CRF, cardiorespiratory fitness; CT, computed tomography; FAC, functional aerobic capacity; IQR, interquartile range; MET, metabolic equivalent.

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Figures

Figure 1
Figure 1
CAC and FAC stratified by age. CAC = coronary artery calcium; FAC = functional aerobic capacity.
Figure 2
Figure 2
CAC and FAC stratified by family history of premature coronary artery disease. CAC = coronary artery calcium; FAC = functional aerobic capacity.
See this image and copyright information in PMC

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References

    1. Möhlenkamp S., Lehmann N., Breuckmann F., et al. Marathon Study Investigators; Heinz Nixdorf Recall Study Investigators. Running: the risk of coronary events: prevalence and prognostic relevance of coronary atherosclerosis in marathon runners. Eur Heart J. 2008;29(15):1903–1910. - PubMed
    1. Schwartz J.G., Merkel-Kraus S., Duval S., et al. Does long-term endurance running enhance or inhibit coronary artery plaque formation? A prospective multidetector CTA study or men completing marathons for at least 25 consecutive years. J Am Coll Cardiol. 2010;55(10A) [abstract]
    1. Laddu D.R., Rana J.S., Murillo R., et al. 25-year physical activity trajectories and development of subclinical coronary artery disease as measured by coronary artery calcium: the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Mayo Clin Proc. 2017;92(11):1660–1670. - PMC - PubMed
    1. Armstrong M.E., Green J., Reeves G.K., Beral V., Cairns B.J., Million Women Study Collaborators Frequent physical activity may not reduce vascular disease risk as much as moderate activity: large prospective study of women in the United Kingdom. Circulation. 2015;131(8):721–729. - PubMed
    1. Mons U., Hahmann H., Brenner H. A reverse J-shaped association of leisure time physical activity with prognosis in patients with stable coronary heart disease: evidence from a large cohort with repeated measurements. Heart. 2014;100(13):1043–1049. - PubMed

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