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Br. J. Sports Med., Jan 15 2025, bjsports-2024-108923 | https://doi.org/10.1136/bjsports-2024-108923
Longitudinal increase in physical activity and adverse cardiovascular outcomes following the diagnosis of acute coronary syndrome
Dong-Hyuk Cho1, Sae Young Jae2, Setor Kunutsor3,4, Jimi Choi5, Jun Gyo Gwon6
1Cardiology, Korea University Anam Hospital, Seoul, Korea (the Republic of)
2Sports Informatics, University of Seoul, Seoul, Korea (the Republic of)
3Cardiology, University of Bristol School of Clinical Science, Winnipeg, Manitoba, Canada
4Leicester General Hospital, University of Leicester, Leicester, UK
5Endocrinology and Metabolism, Korea University Medical Center, Seoul, Korea (the Republic of)
6Vascular Surgery, Asan Medical Center, Songpa-gu, Seoul, Korea (the Republic of)
D-HC and SYJ contributed equally.
Correspondence to Dr Jun Gyo Gwon
1Cardiology, Korea University Anam Hospital, Seoul, Korea (the Republic of)
2Sports Informatics, University of Seoul, Seoul, Korea (the Republic of)
3Cardiology, University of Bristol School of Clinical Science, Winnipeg, Manitoba, Canada
4Leicester General Hospital, University of Leicester, Leicester, UK
5Endocrinology and Metabolism, Korea University Medical Center, Seoul, Korea (the Republic of)
6Vascular Surgery, Asan Medical Center, Songpa-gu, Seoul, Korea (the Republic of)
D-HC and SYJ contributed equally.
Correspondence to Dr Jun Gyo Gwon
Abstract
Objectives: Physical activity (PA) provides protective effects against cardiovascular diseases, including ischaemic heart disease. However, recommending moderate to vigorous PA (MVPA) to patients with recent acute coronary syndrome (ACS) raises concerns owing to potential risk of recurrent ACS or fatal arrhythmias. This study investigated the association between longitudinal PA changes following an ACS diagnosis and subsequent cardiovascular outcomes, including non-fatal coronary events, non-fatal stroke and cardiovascular mortality.
Methods: This longitudinal cohort study used Korean National Health Insurance Service data from 2010 to 2017, comprising 30 840 patients diagnosed with ACS following invasive coronary angiography or bypass surgery. Leisure-time PA was self-reported, with the frequency and intensity measured weekly. The primary endpoint was a composite of nonfatal coronary events, non-fatal stroke and cardiovascular mortality. Multivariable Cox proportional hazards regression models assessed the association between PA changes and cardiovascular outcomes.
Results: Among patients with ACS (mean age: 60±11 years, men: 81.3%), mean PA levels increased from 544±556 metabolic equivalent task (MET)-min/week to 594±567 MET-min/week. Over 6.7 years of median follow-up, 5639 cardiovascular events occurred. Increased PA was associated with lower cardiovascular event risk (HR 0.95, 95% CI 0.92 to 0.98). Consistent MVPA pre-ACS and post-ACS reduced cardiovascular event risk (HR 0.87, 95% CI 0.79 to 0.96) and MVPA initiation showed a modest risk reduction (HR: 0.91, MET-min/95% CI 0.82 to 1.01).
Conclusions: Longitudinal increases in self-reported PA, maintenance of MVPA and possibly MVPA initiation after ACS reduced the risk of cardiovascular events. Initiating or maintaining MVPA could be an important strategy in improving cardiovascular outcomes following ACS.
Methods: This longitudinal cohort study used Korean National Health Insurance Service data from 2010 to 2017, comprising 30 840 patients diagnosed with ACS following invasive coronary angiography or bypass surgery. Leisure-time PA was self-reported, with the frequency and intensity measured weekly. The primary endpoint was a composite of nonfatal coronary events, non-fatal stroke and cardiovascular mortality. Multivariable Cox proportional hazards regression models assessed the association between PA changes and cardiovascular outcomes.
Results: Among patients with ACS (mean age: 60±11 years, men: 81.3%), mean PA levels increased from 544±556 metabolic equivalent task (MET)-min/week to 594±567 MET-min/week. Over 6.7 years of median follow-up, 5639 cardiovascular events occurred. Increased PA was associated with lower cardiovascular event risk (HR 0.95, 95% CI 0.92 to 0.98). Consistent MVPA pre-ACS and post-ACS reduced cardiovascular event risk (HR 0.87, 95% CI 0.79 to 0.96) and MVPA initiation showed a modest risk reduction (HR: 0.91, MET-min/95% CI 0.82 to 1.01).
Conclusions: Longitudinal increases in self-reported PA, maintenance of MVPA and possibly MVPA initiation after ACS reduced the risk of cardiovascular events. Initiating or maintaining MVPA could be an important strategy in improving cardiovascular outcomes following ACS.
논문정보
- Research article
- 2025년 01월 (BRIC 등록일 2025-01-16)
- 국내 연구진
- 의약학 > 응용의학
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