Lifelong endurance sport relative to a generic healthy lifestyle was not linked with more promising coronary plaque composition.

A prospective observational cohort study investigated the connection between coronary atherosclerosis and lifelong endurance exercise.

Overall, 191 late-onset athletes (endurance sports beginning after thirty years of age), 191 lifelong master endurance athletes, and 176 healthy non-athletes, all male with a reduced cardiovascular risk profile were incorporated. Fitness was measured by peak oxygen uptake (VO2peak). The occurrence of coronary plaques (non-calcified, mixed, calcified) on computed tomography coronary angiography was the major outcome. Several cardiovascular risk variables were adjusted in the analyses.

The median age was 55 (50–60) years in the study groups. VO2peak was greater in lifelong and late-onset athletes than in non-athletes (159 [143-177] vs 155 [138-169] vs 122 [108-138]% anticipated). Endurance athletes were at cardiovascular risk with high rates of coronary artery calcium

As compared to a healthy non-athletic lifestyle, lifelong endurance sports were linked with having ≥1 mixed plaque (odds ratio [OR]1.78), ≥1 non-calcified proximal plaque (OR 2.80), ≥1 non-calcified plaque (OR 1.95), ≥1 calcified proximal plaque (OR 2.07), ≥1 calcified plaque (OR 1.58), ≥1 proximal plaque (OR 1.96), and ≥1 coronary plaque (OR 1.86).

Lifelong exercisers had a higher percentage of multiple coronary plaques, plaques ≥ 50%, and proximal plaques. About two-thirds of the plaques in each group were calcified. When looking only at noncalcified plaques, lifelong exercisers tended to have a higher prevalence of multiple plaques, plaques ≥ 50%, and proximal plaques. So named "vulnerable" plaques were extremely infrequent in all three groups.

Compared to healthy lifestyle, participation in lifelong endurance sports is not linked to a more promising coronary plaque composition. In comparison to fit and healthy people with a comparable low cardiovascular risk profile, lifelong endurance athletes exhibited higher coronary plaques, notably higher non-calcified plaques in proximal segments.