Sport-related acute myocardial: occurrence of intraluminal thrombus could be associated with sport intensity

Abstract Funding Acknowledgements Type of funding sources: Other. Main funding source(s): Agence régionale de santé Société Française de Cardiologie. Background Contemporary data addressing coronary artery disease (CAD) characteristics of sport-related acute myocardial infarction (SR-AMI) are scarce and underlying mechanisms are poorly understood, in particular according to metabolic intensity. Purpose To identify coronary angiographic feature of patients with SR-AMI according to sport intensity. Methods From the RICO database, a large regional acute MI survey, all consecutive patients hospitalized in our University Hospital from 2010 to 2021 who underwent coronary angiography for SR-AMI were retrospectively analysed. SR-AMI was defined as MI occurring during sport activity or within the first hour of recovery. Patients were adjudicated according to Ainsworth classification, with a 7 METs (Metabolic Equivalents) cut-off. Results Among the 173 patients included, most were male (n=156(91%)). Median (IQR) age was 60 y (51-67), and had ST segment elevation MI (STEMI) (n= 112 (64%)). The main SR-AMI occurred while cycling (41%), jogging (23%), hiking (9%) or playing soccer (9%). Patients commonly experienced out -of-hospital sudden cardiac arrest (OHSCA) (17%). Atherothrombotic risk factors were dyslipidaemia (34%), current smoking (32%) or hypertension (31%) and history of coronary artery disease (10%). Most (n=156(91%)) had significant lesions, mainly treated by percutaneous coronary intervention (n=131(77%)) or coronary artery bypass grafting (n=11(6%)). In-hospital death occurred in 12 patients (7%), of whom 11 experienced OHSCA- and one was admitted with a cardiogenic shock during the Covid-19 pandemics lockdown. Main clinical and angiographic characteristics are summarized in table 1. Patients in the METs group ≥ 7 were younger, had lower diabetes rates, higher ST-segment elevation MI and had higher rate of intra-luminal thrombus. Conclusion In our large retrospective study, SR-AMI occurring during an elevated intensity exercise had specific angiographic features. Further studies are needed to explore underlying mechanisms of MI according to exercise intensity.