Coronary artery calcification in endurance athletes: a narrative review/ Calcificacao na arteria coronaria em atletas de endurance: uma revisao narrativa

Introduction: cardiovascular disease is the leading cause of death worldwide and coronary artery disease stands out for the number of deaths. Increased coronary artery calcification is a risk factor for coronary events, however, healthy adult men with a high training load over the years and with a history of long endurance tests demonstrate high CAC values. Objective: in view of the paradox between the effects of strenuous physical training and the development of CAC, this study aims to assess the CAC in physically active adult men. Methods: This study is characterized as a narrative review, based on scientific productions in Portuguese and English, in the following databases: National Library of Medicine (PubMed), Scientific Electronic Library Online (SciELO) and US National Library of Medicine (NCBI). Results: In the study,150 of 284 participants (53%) had a median CAC score of 35.8 [9.3-145.8]. The mean lifetime exercise volume was 2.9 [1.9-4.4] hours/ week, resulting in 1356 [851-2030] metabolic equivalent of task (MET)-min/week. In addition, the presence of CAC was more common in those with higher exercise volumes throughout life. As in other studies, it can be considered that higher CAC scores and higher coronary plaques in athletes can be interpreted as a deleterious effect of exercise on the coronary arteries, however, the calcified and stable nature of the plaques in male athletes can also be considered as protective against plaque rupture and acute myocardial infarction. Conclusion: Endurance athletes are more predisposed to increased coronary artery calcification than less active or sedentary individuals, however, what is observed is that high loads of physical exercise throughout life seem to promote more benefits than risk to cardiovascular health. Keywords: Vascular calcification; Athletes; Cardiovascular disease. Introducao: a doenca cardiovascular e a principal causa de morte em todo o mundo e a doenca arterial coronariana se destaca pelo numero de obitos. A calcificacao da arteria coronaria (CAC) aumentada e um fator de risco para eventos coronarianos, no entanto, homens adultos saudaveis com alta carga de treino ao longo dos anos e com historico de longas provas de resistencia demonstram altos valores de CAC. Objetivo: tendo em vista o paradoxo existente entre os efeitos do treinamento fisico extenuante e o desenvolvimento da calcificacao coronariana, o presente estudo tem como objetivo avaliar o mecanismo da CAC em homens adultos fisicam