Aengevaeren et al. 2017, Lifelong exercise and coronary calcium

MARC study of middle-aged men without known coronary disease. The most active group (>2,000 MET-min/week) had a higher coronary artery calcium score and plaque prevalence, but their plaques were more often densely calcified (72% calcified versus 61.5% mixed in less active men). Calcified plaque is more stable and less prone to rupture, which may explain why high CAC in athletes does not carry the event risk it does in the general population. Observational, all-male, cross-sectional. Moderate.