Incidence of major adverse cardiac events in men wishing to continue competitive sport following percutaneous coronary intervention.

BACKGROUND:The new North American guidelines for participation in competitive sport in patients with coronary artery disease (CAD) are less restrictive than previous guidelines. AIM:To evaluate the incidence of major adverse cardiac events (MACE) in men with CAD who practise intensive physical activity after a stenting procedure. MACE included in-stent restenosis (SR), stent thrombosis (ST), new coronary stenosis (NCS), myocardial infarction, heart failure, cardiac arrest or cardiac death. METHODS:Asymptomatic men with CAD and a coronary stent who practised regular (>4h/week) sport were included in this retrospective multicentre observational study. All patients presented with left ventricular ejection fraction≥50%, no residual stenosis, and no inducible ischaemia or arrhythmias. Three groups were compared: those undertaking moderate leisure-time sport (MLS), intensive leisure-time sport (ILS) or competitive sport (CS). During follow-up, all patients had a yearly routine cardiology evaluation. RESULTS:A total of 108 men with CAD (57.3±9.1 years) were included: 29 MLS, 58 ILS, and 21 CS. During follow-up (57.6±46.0 months) the incidence of MACE was 15.7% (SR=5, SR+NCS=4, ST=4, NCS=4) and occurred during physical exertion in 59% of patients. ST was more frequent in the CS (n=3) than in the MLS (n=1) or ILS (n=0) groups, especially in patients with bare-metal stents. CONCLUSIONS:The incidence of MACE was 15.7%, and only ST was significantly more frequent in CS patients than in MLS or ILS patients. Our data support the new US guidelines for exercise eligibility in men with CAD.