IntroductionThe importance of exercise electrocardiogram (ECG) is still controversial in the prevention of cardiovascular events among sportsmen and sportswomen. The aim of this study was to assess the relevance of exercise ECG as a screening tool to prevent cardiovascular events when any cardiovascular disease (CVD) risk factors are present.MethodsThe study included leisure time asymptomatic sportsmen and sportswomen over age 35 evaluated from 2011 to 2016 at the University Hospital of Saint‐Etienne (France). Major adverse cardiovascular events (MACE) and atrial fibrillation were collected at 3 years.ResultsOf the cohort of 2457 sportsmen and sportswomen (mean age 50.2 ± 9.4 years), 50 (2%) had a high‐risk SCORE2. A total of 256 exercise ECGs (10%) were defined as positive, most of them due to silent myocardial ischemia (SMI) (n = 196; 8%). These 196 SMI cases led to 33 coronary angiograms (1%), which revealed 23 significant coronary stenoses requiring revascularization. In multivariate logistic regression analysis, having at least two CVD risk factors was independently associated with (1) positive exercise ECG (OR = 1.80 [95% CI: 1.29–2.52], p = 0.0006), with (2) suspected SMI (OR = 2.57 [95% CI: 1.10–6.02], p = 0.0304), with (3) confirmed SMI (OR = 8.20 [95% CI: 3.46–19.46], p < 0.0001) and with (4) cardiovascular events (MACE or atrial fibrillation) (OR = 6.95 [95% CI: 3.49–13.81], p < 0.0001) at 3 years (median).ConclusionsThe study supports the European recommendations for the use of exercise ECG in evaluation of asymptomatic leisure time sportsmen over age 35. Having at least two CVD risk factors was the best predictor for presence of coronary artery stenosis that may increase the risk for adverse events.Trial Registration: ClinicalTrials.gov Identifier: NCT06024863

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筛选 35 岁以上的男女运动员：运动心电图的相关性。 SEEPRED 研究的数据


简介运动心电图（ECG）在男女运动员预防心血管事件方面的重要性仍存在争议。本研究的目的是评估运动心电图作为存在任何心血管疾病 (CVD) 危险因素时预防心血管事件的筛查工具的相关性。方法该研究包括 2011 年至 2016 年对 35 岁以上闲暇时间无症状运动员进行评估在圣艾蒂安大学医院（法国）。收集 3 年时的主要不良心血管事件 (MACE) 和心房颤动。结果 在 2457 名运动员（平均年龄 50.2 ± 9.4 岁）的队列中，50 名（2%）具有高风险 SCORE2。共有 256 例运动心电图（10%）被定义为阳性，其中大多数是由于无症状心肌缺血（SMI）所致（ n = 196； 8%）。这 196 例 SMI 病例进行了 33 例冠状动脉造影（1%），结果显示 23 例明显的冠状动脉狭窄需要血运重建。在多变量逻辑回归分析中，至少有两个 CVD 危险因素与 (1) 运动心电图阳性独立相关（OR = 1.80 [95% CI: 1.29–2.52]， p = 0.0006），（2）疑似 SMI（OR = 2.57 [95% CI：1.10–6.02]， p = 0.0304），（3）确认 SMI（OR = 8.20 [95% CI：3.46–19.46]， p < 0.0001) 和 (4) 心血管事件（MACE 或心房颤动）（OR = 6.95 [95% CI: 3.49–13.81]， p < 0.0001) 3 年（中位数）。结论该研究支持欧洲关于使用运动心电图评估 35 岁以上无症状休闲运动员的建议。 至少有两个 CVD 危险因素是冠状动脉狭窄存在的最佳预测因素，冠状动脉狭窄可能会增加不良事件的风险。试验注册：临床试验。政府标识符：NCT06024863