Background-Numerous reports suggest sex-related differences in atherosclerosis. Frequency-domain optical coherence tomography has enabled visualization of plaque microstructures associated with disease instability. The prevalence of plaque microstructures between sexes has not been characterized. We investigated sex differences in plaque features in patients with coronary artery disease. Methods and Results-Nonculprit plaques on frequency-domain optical coherence tomography imaging were compared between men and women with either stable coronary artery disease (n=320) or acute coronary syndromes (n=115

Kim et al. (5) reported that the risk of sudden cardiac death in all U.S. marathoners from 2000 to 2010 was 0.0005%, suggesting that cardiotoxicity concerns may be overstated.There are several limitations to our study. The FIT Project describes a measurement of cardiorespiratory fitness in everyday clinical practice with few extreme athletes and cannot be considered a study of cardiotoxicity attributable to EEE. Also, patients in The FIT Project might have been more likely to have other traditional cardiovascular risk factors than ultramarathoners, which may have accentuated the benefits of increasing physical fitness. Finally, although the population was large, our study still lacked sufficient power to model patients with >16 METs, although exploratory analysis suggested a continued mortality decrease in this group.In conclusion, our study suggests a continuous, graded reduction in mortality extending to individuals with an estimated exercise capacity of >14METs. Although more research is needed on the cardiovascular effects of EEE, our data caution against any public health message that might dissuade patients from routine vigorous physical activity with the goal of reaching the highest levels of cardiorespiratory fitness.

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More stable plaque features were observed within non-obstructive atheromas in patients with very low LDL-C levels. These findings underscore LDL-C level to stabilize plaques in patients with CAD and high residual atherosclerotic risk.