Sport-related myocardial infarction: Context of onset, clinical features and one-year follow-up. Results from the IMACS prospective cohort

Context of onset, clinical description, and follow-up of sport-related acute myocardial infarction (SR-AMI) remain only poorly reported. To analyse clinical feature of patients with SR-AMI and their follow-up. From April 2018 to May 2022, all consecutive patients hospitalized for SR-MI were included. SR-AMI was defined as MI occurring during sport practice or within the first hour of recovery. One year follow-up was collected by a phone-call interview. Among the 109 patients included, median age was 62 y (IQR: 55–67), most were male (93.6%), and had ST segment elevation MI (STEMI) (65.1%). The SR-AMI often occurred while or after cycling (33.9%), hiking (11.0%) or jogging (11.0%). Most of heart attack occurred during effort (62.4%). Patients commonly underwent out-of-hospital cardiac arrest (OHCA) (13.8%). The rate of cardiovascular (CV) risk factors was high, including history of CAD (12.8%). Most had one risk factor or more (95.4%), including smoking (25.7%). Among the smokers, 64.3% declared tobacco consumption within the 2 hours before the event. Prodromal symptoms were frequent and occurred during (17.4%) or before the session (34.9%). Follow-up was achieved for each patient enrolled before May 2021 who was discharged alive (78 patients); no further death occurred. Rehabilitation was achieved by 57 patients (71.3%). Tobacco cessation was obtained in 16 of the 18 smokers (88.9%), from whom 2 switched to electronic cigarette. In this large prospective observatory, we documented a high prevalence of prodromal symptoms that were neglected by the patients and common tobacco smoking just before the event. Our findings highlight opportunities to target for prevention programs.