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Physical Activity and Mortality in Patients With Stable Coronary Heart Disease
Auckland City Hosp, Green Lane Cardiovasc Serv, Pk Rd, Auckland 1142, New Zealand..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.ORCID iD: 0000-0001-9402-7404
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
Univ Alberta, Canadian Vigour Ctr, Edmonton, AB, Canada..
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2017 (English)In: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 70, no 14, p. 1689-1700Article in journal (Refereed) Published
Abstract [en]

BACKGROUND Recommendations for physical activity in patients with stable coronary heart disease (CHD) are based on modest evidence.

OBJECTIVES The authors analyzed the association between self-reported exercise and mortality in patients with stable CHD.

METHODS A total of 15,486 patients from 39 countries with stable CHD who participated in the STABILITY (Stabilization of Atherosclerotic Plaque by Initiation of Darapladib Therapy) study completed questions at baseline on hours spent each week taking mild, moderate, and vigorous exercise. Associations between the volume of habitual exercise in metabolic equivalents of task hours/week and adverse outcomes during a median follow-up of 3.7 years were evaluated.

RESULTS A graded decrease in mortality occurred with increased habitual exercise that was steeper at lower compared with higher exercise levels. Doubling exercise volume was associated with lower all-cause mortality (unadjusted hazard ratio [HR]: 0.82; 95% confidence interval [CI]: 0.79 to 0.85; adjusting for covariates, HR: 0.90; 95% CI: 0.87 to 0.93). These associations were similar for cardiovascular mortality (unadjusted HR: 0.83; 95% CI: 0.80 to 0.87; adjusted HR: 0.92; 95% CI: 0.88 to 0.96), but myocardial infarction and stroke were not associated with exercise volume after adjusting for covariates. The association between decrease in mortality and greater physical activity was stronger in the subgroup of patients at higher risk estimated by the ABC-CHD (Age, Biomarkers, Clinical-Coronary Heart Disease) risk score (p for interaction = 0.0007).

CONCLUSIONS In patients with stable CHD, more physical activity was associated with lower mortality. The largest benefits occurred between sedentary patient groups and between those with the highest mortality risk.

Place, publisher, year, edition, pages
ELSEVIER SCIENCE INC , 2017. Vol. 70, no 14, p. 1689-1700
Keywords [en]
cardiac rehabilitation, coronary artery disease, exercise, physical activity
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:uu:diva-336432DOI: 10.1016/j.jacc.2017.08.017ISI: 000411615300001PubMedID: 28958324OAI: oai:DiVA.org:uu-336432DiVA, id: diva2:1166241
Available from: 2017-12-14 Created: 2017-12-14 Last updated: 2017-12-14Bibliographically approved

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Held, ClaesHadziosmanovic, NerminHagström, EmilWallentin, Lars

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