In patients with significant coronary artery calcification (CAC), the recommended amount of exercise is not known. This study aims to value the association of high levels of exercise in patients with CAC and the corresponding risk of all-cause and cause-specific mortality.

This prospective observational cohort study included a total of 21,758 male participants who reported their physical activity level and underwent CAC scanning. Self-reported physical activity was categorized into three metabolic equivalent of task (MET)-minutes per week: at least 3,000, 1,500-2,999, and less than 1,500. The primary outcome of the study was all-cause and cause-specific mortality.

The findings suggested that men with at least 3,000 MET-min/wk were at a higher risk of having prevalent CAC of at list 1000 Agatston units (AU), with a relative risk of 1.11, when compared with other groups with less activity. In the group with physical activity of at least 3,000 MET-min/wk and CAC of at least 100 AU, the mean CAC level was 807 Au. At a mean follow-up of 10.4 years, a total of 759 all-cause and 180 CVD deaths were reported, 40 all-cause deaths, and 10 CVD deaths of which were among those with physical activity of at least 3,000 MET-min/wk.

The research concluded that high levels of physical activity were associated with prevalent CAC but not with all-cause and cardiovascular mortality.