Coronary Atherosclerosis in Former NFL Players

Former professional athletes may be at paradoxically high cardiovascular risk. Retired National Football League players in particular are known to carry a high burden of atherosclerosis risk factors and to be at elevated risk of acute cardiovascular events. We present 3 cases of asymptomatic former National Football League players, each unaware of the presence of coronary artery disease despite prior noninvasive evaluation, who underwent coronary computed tomography angiography coupled with advanced artificial intelligence–enabled analysis as part of an ongoing clinical registry. All 3 former players were found to have previously undiagnosed coronary artery plaque, prompting guideline-directed medical therapy. One patient had early-stage disease burden and 2 had extensive disease, including 1 patient with multiple severe stenoses accompanied by significant physiological impairment and fractional flow reserve reduction who underwent coronary artery bypass surgery. Early patient-specific characterization of coronary artery disease via coronary computed tomography angiography and artificial intelligence–enabled analyses may enable more prompt preventive management and result in clinical risk reduction in this population.