Measuring Athlete's Risk of Cardiovascular Events 3 (MARC-3)
试验速览
- 阶段
- 不适用
- 状态
- Enrolling By Invitation
- 入组人数
- 250
- 试验地点
- 2
研究概览
简要总结
Regular endurance exercise is widely known to improve cardiovascular health and reduce the risk of heart disease. Yet several imaging studies have shown that male endurance athletes have a higher prevalence of coronary artery calcification (CAC) and calcified plaque than less active individuals. It remains unclear whether this represents harmful progression of coronary artery disease or a more benign, stable form of atherosclerosis. Understanding this distinction is essential, because coronary atherosclerosis is the leading cause of exercise-related cardiac events in athletes >35 years.
The MARC-3 study is the second long-term follow-up of the original Measuring Athlete's Risk of Cardiovascular Events (MARC) cohort and aims to clarify how lifelong exercise training influences coronary artery health.
The study will:
- examine how long-term exercise patterns relate to the progression of coronary atherosclerosis;
- assess plaque characteristics using artificial-intelligence based quantitative coronary CT angiography (AI-QCT);
- identify biological markers that may link exercise to plaque development; and
- evaluate long-term clinical outcomes, including all-cause mortality and major adverse cardiovascular events (MACE).
Our working hypothesis is that endurance exercise predominantly leads to more stable, calcified plaque, and that mechanisms such as exercise-induced hypertension, inflammation, lipid regulation, and genetic background may provide an explanation for the unexpected results observed in previous studies.
详细描述
For a detailed description, please see the attached study protocol under 'Documents'.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Cross Sectional
入排标准
- 年龄范围
- 45 Years 至 —（Adult, Older Adult）
- 性别
- Male
- 接受健康志愿者
- 否
入选标准
- •- Previous participation in the original MARC study (enrolled between 2012-2014).
排除标准
- •Inability to provide written informed consent.
- •Not willing to receive information about potential incidental CT findings.
- •Concurrent participation in an interventional study targeting cardiovascular health.
- •Additional exclusion criteria for CCTA:
- •Not willing to undergo CCTA with intravenous contrast.
- •History of severe allergic reaction to iodinated contrast agents.
- •Renal dysfunction (eGFR < 30 mL/min/1.73 m²).
- •Additional exclusion criteria for maximal exercise testing:
- •Absolute contraindications to maximal exercise testing as defined by institutional SOPs, including but not limited to:
- •Recent acute myocardial infarction (3-5 days)
- •Unstable angina
- •Uncontrolled arrhythmias with symptoms or hemodynamic compromise
- •Active endocarditis
- •Acute myocarditis or pericarditis
- •Uncontrolled heart failure
- •Acute pulmonary embolus or pulmonary infarction
- •Lower extremity thrombosis
- •Suspected aortic dissection
- •Uncontrolled asthma
- •Pulmonary edema
- •Resting room-air oxygen saturation ≤ 85 percent
- •Respiratory failure
- •Acute non-cardiopulmonary disorders that impair or are aggravated by exercise (e.g., infection, renal failure, thyrotoxicosis)
- •Mental impairment preventing cooperation
研究组 & 干预措施
MARC-3 cohort
Participants in this cohort are the surviving and traceable members of the original MARC study, which enrolled 318 middle-aged male amateur endurance athletes between 2012 and 2014. In the first follow-up (MARC-2), 291 participants were successfully re-examined. All participants have a lifelong history of regular endurance exercise. In MARC-3, they undergo repeat evaluation of coronary atherosclerosis, cardiopulmonary fitness, exercise exposure, biomarkers, and genetic factors approximately 12.5 years after baseline.
结局指标
主要结局
未指定
次要结局
- Peripheral Atherosclerosis and Vascular Function(Baseline)