Physicians' Academy for Cardiovascular Education

Updated recommendations on sports-participation in athletes-patients with CAD

News - Jan. 11, 2019

Recommendations from the Sports Cardiology section of the European Association of Preventive Cardiology (EAPC) on sports-participation in patients with coronary artery disease (CAD), coronary artery anomalies (CAAs), or spontaneous dissection of the coronary arteries (SCAD), all associated with myocardial ischemia, and in patients with myocardial bridging (MB) have been updated.

Physical inactivity is a risk factor for CAD, and regular physical training lowers the risk of CAD and the risk of sudden cardiac death or arrest during vigorous exertion. Observational data have, however, also indicated that intensive exercise training increases the mortality risk in patients with CAD. Still, the actual incidence of acute events is very low, thus the benefits of regular physical activity and sport participation outweigh the risk for coronary events triggered by acute, intensive activity. Thus, leisure time activity is advised for all individuals with risk factors for, and with manifest CAD. The recommendations, when applied with reasonable precaution, ensure a high level of safety for all individuals with CAD.

In case of lack of scientific evidence, recommendations are based on clinical experience and expert opinion. The available classes and levels of evidence are given in the document. Below is a brief impression of the recommendations.

Asymptomatic athletes-patients with absence of clinically evident CAD:

Athletes-patients with clinically proven CAD:

Athletes-patients with non-CAD-related myocardial ischemia:

All competitive sports are allowed in case of previous surgical correction and lack of persistent, inducible ischemia. In other types of CAA the absence of inducible ischemia should be confirmed and in this case no restriction exists regarding competitive sports participation.

You may also be interested in the following documents:

Find the EAPC position statement on leisure time or competitive sports in those with CAD online at Eur Heart J

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