Coronary Artery Disease in Athletes-Insights from Cardiac CT

Exercise is widely recognized for its cardiovascular benefits, including reduced mortality and a lower risk of cardiovascular events. However, recent studies suggest that athletes may exhibit a paradoxical increase in coronary artery calcium (CAC) and high-risk plaque morphology. Additionally, there is considerable conflicting evidence and numerous gaps in current research on this topic. With the growing population of athletes, particularly “Master Athletes’, understanding the implications of coronary atherosclerosis in this group is increasingly important. ‘Master Athletes’ are typically defined as athletes aged 35 years or older who continue to engage in competitive or high-level physical activity, often participating in endurance sports. This review summarizes the prevalence of coronary artery disease (CAD) in athletes, explores the relationship between physical activity and plaque development, and examines its prognosis in this population. Furthermore, it addresses the appropriate management of athletes with CAD.