Longitudinal increase in physical activity and adverse cardiovascular outcomes following the diagnosis of acute coronary syndrome

IF 11.6 1区 医学 Q1 SPORT SCIENCES
Dong-Hyuk Cho, Sae Young Jae, Setor Kunutsor, Jimi Choi, Jun Gyo Gwon
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引用次数: 0

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. Data are available on reasonable request. The data used in this study are managed by the Korean government and can only be accessed by those with permission from the Korean government.
急性冠状动脉综合征确诊后体力活动的纵向增加与心血管不良后果
体育活动(PA)对包括缺血性心脏病在内的心血管疾病具有保护作用。然而,对近期急性冠脉综合征(ACS)患者推荐中度至重度PA (MVPA)引起了人们的关注,因为可能存在复发性ACS或致死性心律失常的风险。本研究调查了ACS诊断后纵向PA变化与随后的心血管结局(包括非致死性冠状动脉事件、非致死性卒中和心血管死亡率)之间的关系。方法本纵向队列研究使用韩国国民健康保险服务2010年至2017年的数据,包括30840例经有创冠状动脉造影或搭桥手术诊断为ACS的患者。休闲时间PA是自我报告的,频率和强度每周测量一次。主要终点是非致死性冠状动脉事件、非致死性卒中和心血管死亡率的综合。多变量Cox比例风险回归模型评估了PA变化与心血管结局之间的关系。结果在ACS患者中(平均年龄:60±11岁,男性:81.3%),平均PA水平从544±556 MET-min/周增加到594±567 MET-min/周。在6.7年的中位随访中,发生了5639例心血管事件。PA升高与心血管事件风险降低相关(HR 0.95, 95% CI 0.92 ~ 0.98)。一致的MVPA在acs前和acs后降低心血管事件风险(HR 0.87, 95% CI 0.79至0.96),MVPA起始显示适度的风险降低(HR: 0.91, MET-min/95% CI 0.82至1.01)。结论:自报PA的纵向增加、MVPA的维持以及ACS后MVPA的启动降低了心血管事件的风险。启动或维持MVPA可能是改善ACS后心血管预后的重要策略。如有合理要求,可提供资料。本研究使用的数据由韩国政府管理,只有获得韩国政府许可才能访问。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
27.10
自引率
4.90%
发文量
217
审稿时长
3-8 weeks
期刊介绍: The British Journal of Sports Medicine (BJSM) is a dynamic platform that presents groundbreaking research, thought-provoking reviews, and meaningful discussions on sport and exercise medicine. Our focus encompasses various clinically-relevant aspects such as physiotherapy, physical therapy, and rehabilitation. With an aim to foster innovation, education, and knowledge translation, we strive to bridge the gap between research and practical implementation in the field. Our multi-media approach, including web, print, video, and audio resources, along with our active presence on social media, connects a global community of healthcare professionals dedicated to treating active individuals.
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