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June 12, 2026European Journal of Preventive CardiologyOpen Access

Overall diagnostic performance of the exercise stress test for significant CAD was low, with sensitivity 20.8%, specificity 75.3%, PPV 7.8% and NPV 90.4%.

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Why the study?

Does treadmill exercise stress testing accurately detect significant coronary artery disease compared to CCTA in master athletes?

Population

n=293 master athletes followed in a sports cardiology department in Brazil between 2023 and 2025…

Comparison

Treadmill exercise stress testing vs Coronary computed tomography angiography (CCTA)

Design

Cohort

Authors

KNK NascimentoMSM F S SmaniottoYCY G C Cavini

Discussion

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Overview

May warrant caution relying on exercise stress testing alone in master athletes; leaves open optimal CAD screening strategies.

Key Points

  • This study aims to evaluate the effectiveness of exercise stress testing compared to coronary computed tomography angiography (CCTA) in detecting coronary artery disease among master athletes.
  • Registry included 293 master athletes from 2023 to 2025 in Brazil.
  • All underwent treadmill stress testing and CCTA due to abnormal tests or cardiovascular risk factors.
  • Primary risks included dyslipidaemia, diabetes, and hypertension.
  • 199 athletes demonstrated normal exercise test results (67.9%) while 64 showed ischaemia (21.8%).
  • From normal exercise tests, 104 exhibited atherosclerosis, with 19 (18.3%) having significant stenosis.
  • The exercise stress test had a sensitivity of 20.8% and specificity of 75.3% for significant CAD.

Structured PICO

Does treadmill exercise stress testing accurately detect significant coronary artery disease compared to CCTA in master athletes?

P
Population
n=293 master athletes followed in a sports cardiology department in Brazil between 2023 and 2025. Indications for testing included abnormal exercise testing, cardiovascular risk >10% according to the Framingham score, family history of CAD, or atypical chest pain. Most common sports were marathon and mountain running (>50%).
I
Intervention
Treadmill exercise stress testing
C
Comparator
Coronary computed tomography angiography (CCTA)
O
Outcome
Diagnostic performance (sensitivity, specificity, PPV, NPV) for identifying significant coronary artery diseasesurrogate

Exercise stress testing alone has low diagnostic accuracy for detecting significant coronary artery disease in master athletes, highlighting the superior utility of anatomical evaluation with CCTA.

Cite This Study

Nascimento et al. (2026) studied this question.

synapsesocial.com/papers/6a2bd11d6550ea4541ffe8d8https://doi.org/10.1093/eurjpc/zwag249.153
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Coronary Artery Disease in Male Athletes—Is Sport Healthy in the Long Run?2026
  2. 2Coronary computed tomography angiography vs stress testing for stable angina evaluation: Diagnostic and prognostic superiority2025 · 2 citations
  3. 3Utility of Coronary CT Angiography Versus Functional Stress Testing in Patients With Stable Chest Pain: A Systematic Review2025
  4. 4Diagnostic Accuracy of Exercise Stress Testing, Stress Echocardiography, Myocardial Scintigraphy, and Cardiac Magnetic Resonance for Obstructive Coronary Artery Disease: Systematic Reviews and Meta-Analyses of 104 Studies Published from 1990 to 20252025 · 18 citations
  5. 5Masters athletes with abnormal cardiovascular findings: a clinical consensus statement of the European Association of Preventive Cardiology of the ESC and the American College of Cardiology2026 · 8 citations