Rationale for Pre-Race Aspirin to Attenuate Risk for Marathon-Related Cardiac Arrest: Confounding the Legacy of Pheidippides

While increasing levels of recreational sports participation are incrementally cardioprotective, strenuous physical exertion transiently increases the risk for acute cardiac events including sudden death. The frequency marathon-related arrests has been since year 2000 mainly in middle-aged men due to atherosclerotic coronary artery disease. Coronary calcium scores and post-race biomarkers recommended identify runners who might benefit most from pre-race aspirin enhanced primary prevention.