Symptomatic Coronary Artery Disease in a Marathon Runner

Claus A. Pierach, MD
JAMA. 1983;249(7):882. doi:10.1001/jama.1983.03330310017006.
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To the Editor.—  A recent article by Handler et al described a 48-year-old man who had trained in a vigorous running program for approximately eight years and then experienced angina pectoris. Angiography demonstrated a 90% to 99% stenosis of his proximal left anterior descending coronary artery.The authors concluded that "a long distance marathon runner's life-style is not necessarily protective against the progression of coronary atherosclerosis." This may be correct, but a single, probably very rare, case can hardly be considered as sufficient evidence or proof. We do not know if this patient previously had rather extensive coronary atherosclerosis that may have regressed. It is also possible that the isolated high-grade stenosis represented a spasm rather than atherosclerosis.Although nobody should claim running to be a panacea, one could still argue in this well-verified case that the vigorous exercise program may have prolonged this patient's life already. Who knows what


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