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

Summary 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 (>4 h/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.