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

Kim Wadt Hansen, Nina Peytz, Anneke Blokstra, Stig E. Bojesen, Carlos Celis-Morales, Christina Chrysohoou, Els Clays, Dirk De Bacquer, Søren Galatius, Stuart R. Gray, Frederick Ho, Maryam Kavousi, Chantal M. Koolhaas, Matina Kouvari, Maja-Lisa Løchen, Pedro Marques-Vidal, Merete Osler, Demosthenes Panagiotakos, Jill P. Pell, Gerhard SuloGrethe S. Tell, Vassilios Vassiliou, W. M. Monique Verschuren, Eva Prescott

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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.
Original languageEnglish
Pages (from-to)1590–1598
Number of pages9
JournalEuropean Journal of Preventive Cardiology
Volume28
Issue number14
Early online date10 Feb 2021
DOIs
Publication statusPublished - Nov 2021

Keywords

  • Cohort studies
  • Mortality
  • Myocardial infarction
  • Physical activity
  • Pooled analysis

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