University of Oulu

Minna Lahtinen, Tomi Toukola, M. Juhani Junttila, Olli-Pekka Piira, Samuli Lepojärvi, Maria Kääriäinen, Heikki V. Huikuri, Mikko P. Tulppo, Antti M. Kiviniemi, Effect of Changes in Physical Activity on Risk for Cardiac Death in Patients With Coronary Artery Disease, The American Journal of Cardiology, Volume 121, Issue 2, 2018, Pages 143-148, ISSN 0002-9149,

Effect of changes in physical activity on risk for cardiac death in patients with coronary artery disease

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Author: Lahtinen, Minna1; Toukola, Tomi1; Junttila, M. Juhani1;
Organizations: 1Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
2Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 0.6 MB)
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Language: English
Published: Elsevier, 2018
Publish Date: 2019-11-18


Leisure-time physical activity (LTPA) is associated with longevity in patients with coronary artery disease (CAD). However, less is known about prognostic significance of longitudinally assessed LTPA in patients with stable CAD. The present study assessed the relationship between changes in LTPA and cardiac mortality in patients with CAD. Patients with angiographically documented CAD (n = 1,746) underwent clinical examination and echocardiography at the baseline. Lifestyle factors, including LTPA (inactive, irregularly active, active, highly active), were surveyed at baseline and after 2 years’ follow-up. Thereafter, the patients entered the follow-up (median: 4.5 years; first to third quartile: 3.4 to 5.8 years) during which cardiac deaths were registered (n = 68, 3.9%). The patients who remained inactive (n = 114, 18 events, 16%) and became inactive (n = 228, 18 events, 8%) had 7.6- (95% confidence interval [CI] 4.2 to 13.6) and 3.7-fold (95% CI 2.1 to 6.7) univariate risk for cardiac death compared with those who remained at least irregularly active (n = 1,351, 30 events, 2%), respectively. After adjustment for age, gender, body mass index, diabetes, previous myocardial infarction, left ventricular ejection fraction, angina pectoris grading, cardiovascular event during initial 2-year follow-up, smoking and alcohol consumption, the patients who remained inactive and became inactive still had 4.9- (95% CI 2.4 to 9.8, p < 0.001) and 2.4-fold (95% CI 1.3 to 4.5, p < 0.01) risk for cardiac death, respectively, compared with patients remaining at least irregularly active. In conclusion, LTPA has important prognostic value for cardiac death in patients with stable CAD. Even minor changes in LTPA over 2 years were related to the subsequent risk for cardiac death.

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Series: The American journal of cardiology
ISSN: 0002-9149
ISSN-E: 1879-1913
ISSN-L: 0002-9149
Volume: 121
Issue: 2
Pages: 143 - 148
DOI: 10.1016/j.amjcard.2017.10.002
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
Funding: Funded by the Finnish Technology Development Center (TEKES) Helsinki, Finland, the Academy of Finland (#267435), Helsinki, Finland, the Paulo Foundation, Espoo, Finland and the Finnish Foundation for Cardiovascular Research, Helsinki, Finland. The authors appreciate the financial support received from the ARTEMIS consortium partners (Polar Electro, Kempele, Finland and Hur Oy, Kokkola, Finland). The authors gratefully acknowledge the assistance of the registered nurses Pirkko Huikuri, Päivi Koski, Päivi Kastell, and Sari Kaarlenkaski.
Academy of Finland Grant Number: 267435
Detailed Information: 267435 (Academy of Finland Funding decision)
Copyright information: © 2017 Elsevier Inc. All rights reserved. This manuscript version is made available under the CC-BY-NC-ND 4.0 license