PT  - JOURNAL ARTICLE
AU  - Andrea Menafoglio
AU  - Marcello Di Valentino
AU  - Alessandra Pia Porretta
AU  - Pietro Foglia
AU  - Jeanne-Marie Segatto
AU  - Patrick Siragusa
AU  - Reto Pezzoli
AU  - Mattia Maggi
AU  - Gian Antonio Romano
AU  - Giorgio Moschovitis
AU  - Augusto Gallino
TI  - Cardiovascular evaluation of middle-aged individuals engaged in high-intensity sport activities: implications for workload, yield and economic costs
AID  - 10.1136/bjsports-2014-093857
DP  - 2015 Jun 01
TA  - British Journal of Sports Medicine
PG  - 757--761
VI  - 49
IP  - 11
4099  - http://bjsm.bmj.com/content/49/11/757.short
4100  - http://bjsm.bmj.com/content/49/11/757.full
SO  - Br J Sports Med2015 Jun 01; 49
AB  - Background The European Association of Cardiovascular Prevention and Rehabilitation (EACPR) recommends cardiovascular evaluation of middle-aged individuals engaged in sport activities. However, very few data exist concerning the impact of such position stand. We assessed the implications on workload, yield and economic costs of this preventive strategy. Methods Individuals aged 35–65 years engaged in high-intensity sports were examined following the EACPR protocol. Athletes with abnormal findings or considered at high-cardiovascular risk underwent additional examinations. The costs of the overall evaluation until diagnosis were calculated according to Swiss medical rates. Results 785 athletes (73% males, 46.8±7.3 years) were enrolled over a 13-month period. Among them, 14.3% required additional examinations: 5.1% because of abnormal ECG, 4.7% due to physical examination, 4.1% because of high-cardiovascular risk and 1.6% due to medical history. A new cardiovascular abnormality was established in 2.8% of athletes, severe hypercholesterolaemia in 1% and type 2 diabetes in 0.1%. Three (0.4%) athletes were considered ineligible for high-intensity sports, all of them discovered through an abnormal ECG. No athlete was diagnosed with significant coronary artery disease on the basis of a high-risk profile or an exercise ECG. The cost was US$199 per athlete and US$5052 per new finding. Conclusions Cardiovascular evaluation of middle-aged athletes detected a new cardiovascular abnormality in about 3% of participants and a high-cardiovascular risk profile in about 4%. Some of these warranted exclusion of the athlete from high-intensity sport. The overall evaluation seems to be feasible at reasonable costs.