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Prerace aspirin to protect susceptible runners from cardiac arrest during marathons: is opportunity knocking?

Siegel AJ - Open Heart (2015)

Bottom Line: An evidence-based strategy for prevention is considered based on identifying atherothrombosis as the underlying cause in this susceptible subgroup.Review of all articles on PubMed related to acute cardiac events during marathons.Inflammatory biomarkers predicting acute cardiac events and hypercoagulability with in vivo platelet activation were demonstrated in same-aged asymptomatic middle-aged men during marathons.

View Article: PubMed Central - PubMed

Affiliation: Internal Medicine , McLean Hospital , Belmont, Massachusetts , USA ; Harvard Medical School , Boston, Massachusetts , USA.

ABSTRACT
While endurance exercise such as marathon training is cardioprotective, an increasing frequency of race-related cardiac arrests and sudden death has been observed in middle-aged men since the year 2000. An evidence-based strategy for prevention is considered based on identifying atherothrombosis as the underlying cause in this susceptible subgroup. Review of all articles on PubMed related to acute cardiac events during marathons. Male gender and the marathon compared with the half-marathon were identified as significant risk factors for race-related cardiac arrests, which events increased 2.3-fold in the latter half of a 10-year prospective registry beginning in the year 2000. There were 50 cardiac arrests in runners who were 86% male with a mean age of 42 years. The main cause of sudden death was atherosclerotic heart disease in those over the age of 40 including myocardial infarction in 12 of 13 (93%) cases over the age of 45 as assessed retrospectively. Inflammatory biomarkers predicting acute cardiac events and hypercoagulability with in vivo platelet activation were demonstrated in same-aged asymptomatic middle-aged men during marathons. Excess cardiac morbidity and mortality in middle-aged men during marathons is mediated by atherothrombosis which may render non-obstructive coronary atherosclerotic plaques vulnerable to rupture. Prerace low-dose aspirin usage is prudent to protect susceptible runners from a high, if transient, risk for cardiac arrest during races as evidence-based to prevent first myocardial infarctions in same-aged healthy men.

No MeSH data available.


Related in: MedlinePlus

Rationale for prerace aspirin usage to protect susceptible runners from cardiac arrest during marathons
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OPENHRT2014000102F2: Rationale for prerace aspirin usage to protect susceptible runners from cardiac arrest during marathons

Mentions: Analogous to the urgent advisory by the US Food and Drug Administration on excess sudden cardiac death associated with short-course azithromycin,4041 what message should be conveyed to susceptible males regarding this same risk during marathon running? The recommendation for middle-aged men to take prerace aspirin on approval by their physicians was provided in the programme of the 2014 Rio de Janeiro marathon by its medical director, Paulo Afonso Lourega de Menezes.42 As with excess sudden cardiac death with azithromycin, disclosure allows susceptible males to participate cognisant of transiently high short-term cardiac risk and with the benefit of cardioprotective measures (figure 2).43


Prerace aspirin to protect susceptible runners from cardiac arrest during marathons: is opportunity knocking?

Siegel AJ - Open Heart (2015)

Rationale for prerace aspirin usage to protect susceptible runners from cardiac arrest during marathons
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4493166&req=5

OPENHRT2014000102F2: Rationale for prerace aspirin usage to protect susceptible runners from cardiac arrest during marathons
Mentions: Analogous to the urgent advisory by the US Food and Drug Administration on excess sudden cardiac death associated with short-course azithromycin,4041 what message should be conveyed to susceptible males regarding this same risk during marathon running? The recommendation for middle-aged men to take prerace aspirin on approval by their physicians was provided in the programme of the 2014 Rio de Janeiro marathon by its medical director, Paulo Afonso Lourega de Menezes.42 As with excess sudden cardiac death with azithromycin, disclosure allows susceptible males to participate cognisant of transiently high short-term cardiac risk and with the benefit of cardioprotective measures (figure 2).43

Bottom Line: An evidence-based strategy for prevention is considered based on identifying atherothrombosis as the underlying cause in this susceptible subgroup.Review of all articles on PubMed related to acute cardiac events during marathons.Inflammatory biomarkers predicting acute cardiac events and hypercoagulability with in vivo platelet activation were demonstrated in same-aged asymptomatic middle-aged men during marathons.

View Article: PubMed Central - PubMed

Affiliation: Internal Medicine , McLean Hospital , Belmont, Massachusetts , USA ; Harvard Medical School , Boston, Massachusetts , USA.

ABSTRACT
While endurance exercise such as marathon training is cardioprotective, an increasing frequency of race-related cardiac arrests and sudden death has been observed in middle-aged men since the year 2000. An evidence-based strategy for prevention is considered based on identifying atherothrombosis as the underlying cause in this susceptible subgroup. Review of all articles on PubMed related to acute cardiac events during marathons. Male gender and the marathon compared with the half-marathon were identified as significant risk factors for race-related cardiac arrests, which events increased 2.3-fold in the latter half of a 10-year prospective registry beginning in the year 2000. There were 50 cardiac arrests in runners who were 86% male with a mean age of 42 years. The main cause of sudden death was atherosclerotic heart disease in those over the age of 40 including myocardial infarction in 12 of 13 (93%) cases over the age of 45 as assessed retrospectively. Inflammatory biomarkers predicting acute cardiac events and hypercoagulability with in vivo platelet activation were demonstrated in same-aged asymptomatic middle-aged men during marathons. Excess cardiac morbidity and mortality in middle-aged men during marathons is mediated by atherothrombosis which may render non-obstructive coronary atherosclerotic plaques vulnerable to rupture. Prerace low-dose aspirin usage is prudent to protect susceptible runners from a high, if transient, risk for cardiac arrest during races as evidence-based to prevent first myocardial infarctions in same-aged healthy men.

No MeSH data available.


Related in: MedlinePlus