Update: recommendations sports-participation in CAD patients-athletes
It is known that regular exercise training reduces the risk for coronary artery disease (CAD), cardiac death and cardiac arrest, whereas intensive physical exercise increases the risk for mortality in CAD patients. However, the benefits of regular exercise training outweigh by far the increased risk by intensive physical exercise.
The article discusses recommended exercise intensities for patients-athletes with (a)symptomatic CAD, discriminating between competitive sports, high-intensity exercise and all kinds of exercise intensities. Also, advice for sports-participation in patients-athletes with known risk factors for cardiac events is given and the role of different diagnostic endpoints in recommendations for exercise intensities are presented. Especially when patient-athletes want to engage in competitive sports, it is important to carefully balance the documented benefits of exercise programs with the potential risk for adverse events. Adverse events can differ depending on the specific type of sport.
Recommendations are based on the available evidence where possible, but since often sound scientific evidence is lacking, other advice is based on clinical experience and expert opinion. The available class and level of evidence is given for each recommendation.
Leisure time activity should be recommended individually to all those with manifest CAD or with risk factors for CAD. Competitive sports should only be restricted when a substantial risk of adverse events or disease progression exists. Overall, the updated document aims to encourage regular physical activity, including participation in sports and, which reasonable precaution, to ensure a high level of safety for all individuals with CAD.