Coronary artery calcification (CAC) is a strong marker of subclinical coronary atherosclerosis and leading authorities recommend CAC scoring to help inform patient management decisions in cardiovascular disease (CVD) prevention.1 2 This will result in an increasing number of athlete-patients with subclinical coronary atherosclerosis presenting to sport and exercise medicine physicians, raising questions about exercise recommendations in this subgroup. With a specific focus on the recent outcomes data of DeFina and colleagues3 we extend our recent discussion of the topic2 by focusing on how to manage athlete-patients with elevated CAC in the sport and exercise medicine setting. A breakthrough in reporting the association of CAC and mortality risk across different activity levels came from a recent study of 21 758 healthy male participants without prevalent CVD. Higher levels of leisure-time physical activity were associated with a lower risk of mortality at any given level of CAC.3 The authors reported a higher risk metabolic profile (ie, higher baseline blood pressure, higher glucose concentrations and higher triglycerides) in the high volume exercise group with elevated CAC ≥100 AU …

中文翻译：

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您的运动员患者的冠状动脉钙化评分很高——“铁石心肠”。你应该建议什么？运动安全吗？

冠状动脉钙化 (CAC) 是亚临床冠状动脉粥样硬化的重要标志物，主要权威机构推荐 CAC 评分以帮助患者在心血管疾病 (CVD) 预防方面做出管理决策。1 2 这将导致越来越多的运动员患有亚临床冠状动脉粥样硬化动脉粥样硬化呈现给运动和运动医学医师，提出了关于该亚组运动建议的问题。特别关注 DeFina 及其同事 3 的近期结果数据，我们扩展了我们最近对该主题的讨论 2，重点关注如何在运动和运动医学环境中管理 CAC 升高的运动员患者。最近一项针对 21 758 名没有普遍 CVD 的健康男性参与者的研究在报告不同活动水平的 CAC 和死亡风险之间的关联方面取得了突破。在任何给定的 CAC 水平下，较高水平的休闲时间体力活动与较低的死亡风险相关 3。 CAC升高≥100 AU的容量运动组……