Rationale and design of the Measuring Athlete’s Risk of Cardiovascular events (MARC) study

Abstract

BackgroundMore than 90 % of exercise-related cardiac arrests occur in men, predominantly those aged 45 years and older with coronary artery disease (CAD) as the main cause. The current sports medical evaluation (SME) of middle-aged recreational athletes consists of a medical history, physical examination, and resting and exercise electrocardiography. Coronary CT (CCT) provides a minimally invasive low radiation dose opportunity to image the coronary arteries. We present the study protocol of the Measuring Athlete’s Risk of Cardiovascular events (MARC) study. MARC aims to assess the additional value of CCT to a routine SME in asymptomatic sportsmen ≥45 years without known CAD.DesignMARC is a prospective study of 300 asymptomatic sportsmen ≥45 years who will undergo CCT if the SME does not reveal any cardiac abnormalities. The prevalence and determinants of CAD (coronary artery calcium score ≥100 Agatston Units (AU) or ≥50 % luminal stenosis) will be reported. The number needed to screen to prevent the occurrence of one cardiovascular event in the next 5 years, conditional to adequate treatment, will be estimated.DiscussionWe aim to determine the prevalence and severity of CAD and the additional value of CCT in asymptomatic middle-aged (≥45 years) sportsmen whose routine SME revealed no cardiac abnormalities.Electronic supplementary materialThe online version of this article (doi:10.1007/s12471-014-0630-0) contains supplementary material, which is available to authorized users.

No psychological distress in sportsmen aged 45 years and older after cardiovascular screening, including cardiac CT: The Measuring Athlete’s Risk of Cardiovascular events (MARC) study

“…The design and main results of the Measuring Athlete’s Risk of Cardiovascular events (MARC) study have been published [ 18 , 19 ]. The study has been approved by the regional medical ethics committee.…”

Relationship Between Lifelong Exercise Volume and Coronary Atherosclerosis in Athletes

“…This is an analysis of the Measuring Athlete's Risk of Cardiovascular Events (MARC) study, whose rationale and design have been published previously 20 . Men aged 45 years or older were eligible if they were asymptomatic, engaged in competitive or recreational leisure sports, were free of known CVD and had undergone a sports medical examination with bicycle exercise ECG that revealed no abnormalities, according to the responsible physician.…”

Sudden cardiac death in athletes

“…CT can be used for assessment in athletes with risk factors of atherosclerosis, especially those with positive family history of premature CAD. The ongoing MARC trial addresses this issue in the athletic population [48]. Besides the need for radiation, the expected low percentage of positive findings requires thorough cost-effectiveness of CT assessment.…”