TY - JOUR T1 - Risk of atrial fibrillation and stroke among older men exposed to prolonged endurance sport practice: a 10-year follow-up. The Birkebeiner Ageing Study and the Tromsø Study JF - Open Heart JO - Open Heart DO - 10.1136/openhrt-2022-002154 VL - 9 IS - 2 SP - e002154 AU - Kristoffer Robin Johansen AU - Anette Hylen Ranhoff AU - Eivind Sørensen AU - Bjarne M Nes AU - Kim Arne Heitmann AU - Turid Apelland AU - Silvana Bucher Sandbakk AU - Tom Wilsgaard AU - Maja-Lisa Løchen AU - Dag S Thelle AU - Bente Morseth AU - Marius Myrstad A2 - , Y1 - 2022/11/01 UR - http://openheart.bmj.com/content/9/2/e002154.abstract N2 - Aims Endurance sport practice is associated with a high prevalence of atrial fibrillation (AF), which increases the risk of stroke in the general population. However, stroke risk in endurance athletes with AF is sparsely investigated. Most studies have been limited by design and are largely restricted to younger and middle-aged populations. Thus, we aimed to investigate AF and stroke risk in older athletes exposed to prolonged endurance training.Method During a 10-year period, 505 male athletes aged ≥65 years frequently participating in a long-distance ski race were compared with 1867 men of the same age from the general population. The main exposure was endurance sport practice with self-reported AF and stroke as outcomes. Stroke risk was further examined by joint modelling of AF and endurance practice. Statistical analysis was conducted with a modified Poisson model.Results Athletes (median age: 68, range: 65–90) participated in a long-distance ski race over a median of 14 years (range: 1–53). Prevalence (28.5% vs 17.8%) and adjusted risk of AF (risk ratio (RR): 1.88, 95% CI: 1.49 to 2.37) were higher in athletes compared with non-athletes, whereas the prevalence (5.4% vs 9.7%) and risk of stroke were lower (RR: 0.60, 95% CI: 0.37 to 0.95). Compared with athletes without AF, risk of stroke was twofold in athletes (RR: 2.38, 95% CI: 1.08 to 5.24) and nearly fourfold in non-athletes (RR: 3.87, 95% CI: 1.98 to 7.57) with AF.Conclusion Although older male endurance athletes experienced an increased risk of AF, the long-term risk of stroke was substantially reduced compared with non-athletes.Data are available on reasonable request. Data may be obtained from a third party and are not publicly available. The data underlying this article cannot be shared publicly due to GDPR regulations but is available on request. The legal restrictions on data availability are set by the Tromsø Study Data and Publication Committee in order to control for data sharing, including publication of datasets with the potential of reverse identification of de-identified sensitive participant information. The data can however be made available on application to the Tromsø Study Data and Publication Committee. Contact information: The Tromsø Study, Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway; e-mail: tromsous@uit.no. The datasets generated in BiAS are not publicly available as the study is not yet completed but may be available on reasonable request. The Stata code used for the main analysis is available on reasonable request. ER -