Association of fatal myocardial infarction with past level of physical activity: a pooled analysis of cohort studies

Author:

Hansen Kim Wadt1,Peytz Nina2,Blokstra Anneke3,Bojesen Stig E2,Celis-Morales Carlos4,Chrysohoou Christina5,Clays Els6,De Bacquer Dirk6,Galatius Søren1,Gray Stuart R4,Ho Frederick4,Kavousi Maryam7,Koolhaas Chantal M7,Kouvari Matina8,Løchen Maja-Lisa9,Marques-Vidal Pedro10,Osler Merete11,Panagiotakos Demosthenes8,Pell Jill P12,Sulo Gerhard13,Tell Grethe S14,Vassiliou Vassilios15,Verschuren W M Monique3,Prescott Eva1

Affiliation:

1. Department of Cardiology, Bispebjerg Frederiksberg University Hospital, Bispebjerg Bakke 23, Building 67, 1st floor, DK-2400 Copenhagen, Denmark

2. Department of Clinical Medicine, Herlev Gentofte University Hospital, Copenhagen, Denmark

3. Department of Life Course and Health, National Institute for Public Health and the Environment, Bilthoven, The Netherlands

4. BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular & Medical Sciences, University of Glasgow, Glasgow, UK

5. First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece

6. Department of Public Health and Primary Care, University Ghent, Ghent, Belgium

7. Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands

8. Department of Nutrition – Dietetics, School of Health Science and Education, Harokopio University of Athens, Athens, Greece

9. Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway

10. Department of Medicine, Internal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland

11. Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg University Hospitals, Copenhagen, Denmark

12. Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK

13. Centre for Disease Burden, Norwegian Institute of Public Health, Bergen, Norway

14. Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway

15. Norwich Medical School, University of East Anglia, Norwich and Imperial College London, UK

Abstract

Abstract Aims To assess the association between past level of physical activity (PA) and risk for death during the acute phase of myocardial infarction (MI) in a pooled analysis of cohort studies. Methods and results European cohorts including participants with a baseline assessment of PA, conventional cardiovascular (CV) risk factors, and available follow-up on MI and death were eligible. Patients with an incident MI were included. Leisure-time PA was grouped as sedentary (<7 MET-hours), low (7–16 MET-hours), moderate (16.1–32 MET-hours), or high (>32 MET-hours) based on calculated net weekly energy expenditure. The main outcome measures were instant and 28-day case fatality of MI. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using multivariate random-effects models. Adjustments for age, sex, CV risk factors, alcohol consumption, and socioeconomic status were made. From 10 cohorts including a total of 1 495 254 participants, 28 140 patients with an incident MI comprised the study population. A total of 4976 (17.7%) died within 28 days—of these 3101 (62.3%) were classified as instant fatal MI. Compared with sedentary individuals, those with a higher level of PA had lower adjusted odds of instant fatal MI: low PA [OR, 0.79 (95% CI, 0.60–1.04)], moderate PA [0.67 (0.51–0.89)], and high PA [0.55 (0.40–0.76)]. Similar results were found for 28-day fatal MI: low PA [0.85 (0.71–1.03)], moderate PA [0.64 (0.51–0.80)], and high PA [0.72 (0.51–1.00)]. A low-to-moderate degree of heterogeneity was detected in the analysis of instant fatal MI (I2 = 47.3%), but not in that of 28-day fatal MI (I2 = 0.0%). Conclusion A moderate-to-high level of PA was associated with a lower risk of instant and 28-day death in relation to a MI.

Funder

The Danish Heart Foundation

Publisher

Oxford University Press (OUP)

Subject

Cardiology and Cardiovascular Medicine,Epidemiology

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