Premorbid physical activity and prognosis after incident myocardial infarction: The atherosclerosis risk in communities study

Johns Hopkins Bloomberg School of Public Health. Department of Epidemiology. Baltimore, MD, USA / Johns Hopkins Bloomberg School of Public Health. Welch Center for Prevention, Epidemiology and Clinical Research. Baltimore, MD, USA.
University of North Carolina at Chapel Hill. Gillings School of Global Public Health. Department of Epidemiology. Chapel Hill, NC, USA.
Johns Hopkins Bloomberg School of Public Health. Department of Epidemiology. Baltimore, MD, USA / Johns Hopkins Bloomberg School of Public Health. Welch Center for Prevention, Epidemiology and Clinical Research. Baltimore, MD, USA / New York University Grossman School of Medicine. Optimal Aging Institute. New York, NY, USA / New York University Grossman School of Medicine. Department of Population Health. New York, NY, USA.
Johns Hopkins Bloomberg School of Public Health. Department of Epidemiology. Baltimore, MD, USA / Johns Hopkins Bloomberg School of Public Health. Welch Center for Prevention, Epidemiology and Clinical Research. Baltimore, MD, USA / New York University Grossman School of Medicine. Optimal Aging Institute. New York, NY, USA / New York University Grossman School of Medicine. Department of Population Health. New York, NY, USA.
University of North Carolina at Chapel Hill. Gillings School of Global Public Health. Department of Epidemiology. Chapel Hill, NC, USA.
Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Disease. Chagas Disease Clinical Research Laboratory. Rio de Janeiro, RJ, Brazil / National Institute of Cardiology. Department of Research and Education. Rio de Janeiro, RJ, Brazil.
Johns Hopkins Bloomberg School of Public Health. Department of Epidemiology. Baltimore, MD, USA / Tel-Aviv University. Faculty of Medicine. Stanley Steyer School of Health Professions. Tel Aviv, Israel.
Johns Hopkins Bloomberg School of Public Health. Department of Epidemiology. Baltimore, MD, USA / Johns Hopkins Bloomberg School of Public Health. Welch Center for Prevention, Epidemiology and Clinical Research. Baltimore, MD, USA.
Columbia University Irving Medical Center. Department of Medicine. Division of General Medicine. New York, NY, USA.
Johns Hopkins Bloomberg School of Public Health. Department of Epidemiology. Baltimore, MD, USA / Johns Hopkins Bloomberg School of Public Health. Welch Center for Prevention, Epidemiology and Clinical Research. Baltimore, MD, USA / New York University Grossman School of Medicine. Optimal Aging Institute. New York, NY, USA / New York University Grossman School of Medicine. Department of Population Health. New York, NY, USA.
University of North Carolina at Chapel Hill. Gillings School of Global Public Health. Department of Epidemiology. Chapel Hill, NC, USA.
Johns Hopkins Bloomberg School of Public Health. Department of Epidemiology. Baltimore, MD, USA / Johns Hopkins Bloomberg School of Public Health. Welch Center for Prevention, Epidemiology and Clinical Research. Baltimore, MD, USA.

Abstract

Background: High to moderate levels of physical activity (PA) are associated with low risk of incident cardiovascular disease. However, it is unclear whether the benefits of PA in midlife extend to cardiovascular health following myocardial infarction (MI) in later life. Methods: Among 1,111 Atherosclerosis Risk in Communities study participants with incident MI during Atherosclerosis Risk in Communities follow-up (mean age 73 [SD 9] years at MI, 54% men, 21% Black), PA on average 11.9 (SD 6.9) years prior to incident MI (premorbid PA) was evaluated as the average score of PA between visit 1 (1987-1989) and visit 3 (1993-1995) using a modified Baecke questionnaire. Total and domain-specific PA (sport, nonsport leisure, and work PA) was analyzed for associations with composite and individual outcomes of mortality, recurrent MI, and stroke after index MI using multivariable Cox models. Results: During a median follow-up of 4.6 (IQI 1.0-10.5) years after incident MI, 823 participants (74%) developed a composite outcome. The 10-year cumulative incidence of the composite outcome was lower in the highest, as compared to the lowest tertile of premorbid total PA (56% vs. 70%, respectively). This association remained statistically significant even after adjusting for potential confounders (adjusted hazard ratio [aHR] 0.80 [0.67-0.96] for the highest vs. lowest tertile). For individual outcomes, high premorbid total PA was associated with a low risk of recurrent MI (corresponding aHR 0.64 [0.44, 0.93]). When domain-specific PA was analyzed, similar results were seen for sport and work PA. The association was strongest in the first year following MI (e.g., aHR of composite outcome 0.66 [95% CI 0.47, 0.91] for the highest vs. lowest tertile of total PA). Conclusions: Premorbid PA was associated positively with post-MI cardiovascular health. Our results demonstrate the additional prognostic advantages of PA beyond reducing the risk of incident MI.

Keywords

Premorbid physical activity
Myocardial infarction
Atherosclerosis
Cardiovascular disease

Publisher

Elsevier

Citation

MOK, Yejin et al. Premorbid physical activity and prognosis after incident myocardial infarction: The atherosclerosis risk in communities study. American Heart Journal, v. 274, p. 75-83, Aug. 2024.

DOI

10.1016/j.ahj.2024.05.005

ISSN

0002-8703

Please use this identifier to cite or link to this item: https://www.arca.fiocruz.br/handle/icict/65152

Type

Copyright

Restricted access

Embargo date

2030-12-31

Collections

Share

Statistics

Metadata

Author

Affilliation