Acute cardiac events in recreational athletes during endurance sports (cycling, marathons and triathlons) have increased in frequency since 2000 worldwide (United States, Europe, South Africa and Japan), mainly in middle-aged men with subclinical coronary atherosclerosis1-7. An Incidence of 1 per 34,000-50,000 participants with a mean age in the mid-40s warrants expeditious counter measures based on the understanding that atherothrombosis is the root cause.