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Physical inactivity and smoking after myocardial infarction as predictors for readmission and survival: results from the SWEDEHEART-registry
Swedish Sch Sport & Hlth Sci, Astrand Lab Work Physiol, POB 5626, S-11486 Stockholm, Sweden;Karolinska Univ Hosp, Allied Hlth Profess Funct, Funct Area Occupat Therapy & Physiotherapy, Stockholm, Sweden.ORCID iD: 0000-0001-9833-8306
Swedish Sch Sport & Hlth Sci, Astrand Lab Work Physiol, POB 5626, S-11486 Stockholm, Sweden.
Falun Cent Hosp, Dept Cardiol, Falun, Sweden.
Gothenburg Univ, Dept Neurosci & Physiol, Gothenburg, Sweden;Sahlgrens Univ Hosp, Gothenburg, Sweden.
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2019 (English)In: Clinical Research in Cardiology, ISSN 1861-0684, E-ISSN 1861-0692, Vol. 108, no 3, p. 324-332Article in journal (Refereed) Published
Abstract [en]

Background

Physical activity (PA) and smoking cessation are included in the secondary prevention guidelines after myocardial infarction (MI), but they are still underutilised. This study aims to explore how PA level and smoking status (6-10weeks post-MI) were associated with 1-year readmission and mortality during full follow-up time, and with the cumulative 5-year mortality.

Methods

A population-based cohort of all hospitals providing MI-care in Sweden (SWEDEHEART-registry) in 2004-2014. PA was expressed as the number of exercise sessions of 30min in the last 7days: 0-1 (low), 2-4 (medium) and 5-7 (high) sessions/week. Individuals were categorised as smokers, former smokers or never-smokers. The associations were analysed by unadjusted and adjusted logistic and Cox regressions.

Results

During follow-up (M=3.58years), a total of 1702 deaths occurred among 30 644 individuals (14.1 cases per 1000 person-years). For medium and high PA, the hazard ratios (HRs) for mortality were 0.39 and 0.36, respectively, compared with low PA. For never-smokers, the HR was 0.45 and former smokers 0.56 compared with smokers. Compared with low PA, the odds ratios (ORs) for readmission in medium PA were 0.65 and 0.59 for CVD and non-CVD causes, respectively. For high PA, the corresponding ORs were 0.63 and 0.55. The association remained in adjusted models. There were no associations between smoking status and readmission.

Conclusions

The PA level and smoking status are strong predictors of mortality post-MI and the PA level also predicts readmission, highlighting the importance of adherence to the secondary prevention guidelines.

Place, publisher, year, edition, pages
2019. Vol. 108, no 3, p. 324-332
Keywords [en]
Myocardial ischaemia, Physical activity, Tobacco, Survival, Hospitalisation
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:uu:diva-379026DOI: 10.1007/s00392-018-1360-xISI: 000459158700012PubMedID: 30167806OAI: oai:DiVA.org:uu-379026DiVA, id: diva2:1295616
Available from: 2019-03-12 Created: 2019-03-12 Last updated: 2019-03-12Bibliographically approved

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