Coronary Artery Calcium in the Highly Active Not Linked with Increased Mortality

Highly active individuals with elevated coronary artery calcium (CAC) levels did not experience an increased risk for mortality from those high activity levels, new study results from the Cooper Center Longitudinal Study suggest.

The observational study included 21,758 men without prevalent cardiovascular disease and with varying levels of physical activity. Self-reported physical activity was categorized into groups according to metabolic equivalent task (MET)-minutes per week (at least 3,000 MET-min/wk: n=1,561; 1,000 to 2,999 MET-min/wk: n=3,750; and less than 1,500 MET-min/wk: n=16,477), with CAC scores categorized into 2 groups of either at least 100 (n=5,314) and less than 100 (n=16,444) Agatston Units (AU). The primary study outcomes were all-cause and cardiovascular disease(CVD) mortality.

According to the results, men with at least 3,000 MET-mins/wk were more likely to have CAC of at least 100 AU compared to those with less physical activity. Those with CAC scores less than 100 AU and physical activity of less than 3,000 MET-mins/wk were half as likely to die as those with less than 1,500 MET-min/wk (HR=0.52; 95% CI, 0.29 to 0.91). There was no significant increase in all-cause mortality in the most active group. In the least active group, those with CAC scores of at least 100 AU were twice as likely to die from CVD compared to those with scores of less than 100 AU (HR=1.93; 95% CI, 1.34 to 2.78).

“In highly active individuals with elevated levels of coronary artery calcification, it appears that there is no evidence to suggest increased mortality risk from high levels of physical activity,” the researchers wrote in their study.

High levels of physical activity do not predispose one to all-cause or cardiovascular death even in the presence of coronary artery calcium. https://t.co/20TIFVJeYe pic.twitter.com/f5PwD8axcN

— JAMA Cardiology (@JAMACardio) January 30, 2019

I'm willing to bet this pertains to me. I blame @kofi_larry, but glad it doesn't clearly impart harm. Association of Mortality With High Levels of Physical Activity and Coronary Artery Calcification https://t.co/qTDgqq8nFQ

— Steve Bradley (@sbradley_heart) January 30, 2019

Just out, coronary calcium scores are higher and do not predict worse outcome in highly active individuals. Meaning peak VO2 is a more accurate predictor of long-term outcomes than coronary calcium score: https://t.co/U3uQx3hNan

— Sundeep Chaudhry (@ChaudhrySundeep) January 30, 2019

New paper in @JAMACardio showing high physical activity associated with good prognosis despite *more* CAC in high activity group.https://t.co/usBwJUlYbT

— Venk Murthy MD PhD (@venkmurthy) January 30, 2019

No reason to be afraid of high levels of physical activity, even if you have a “Heart of Stone” @JAMACardio @CERG_NTNU @UWisloff https://t.co/Qaowe60voJ

— Trine Moholdt (@trinemoholdt) January 31, 2019

https://twitter.com/LeisBenjamin/statuses/1090808920321318913

Source: JAMA Cardiology