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

• Published in: European journal of preventive cardiology 2021-12, Vol.28 (14), p.1590-1598
• Main Authors: Hansen, Kim Wadt, Peytz, Nina, Blokstra, Anneke, Bojesen, Stig E, Celis-Morales, Carlos, Chrysohoou, Christina, Clays, Els, De Bacquer, Dirk, Galatius, Søren, Gray, Stuart R, Ho, Frederick, Kavousi, Maryam, Koolhaas, Chantal M, Kouvari, Matina, Løchen, Maja-Lisa, Marques-Vidal, Pedro, Osler, Merete, Panagiotakos, Demosthenes, Pell, Jill P, Sulo, Gerhard, Tell, Grethe S, Vassiliou, Vassilios, Verschuren, W M Monique, Prescott, Eva
• Format: Article
• Language: English
• Subjects: Cohort Studies; Epidemiologi medisinsk og odontologisk statistikk: 803; Epidemiology medical and dental statistics: 803; Exercise; Health sciences: 800; Helsefag: 800; Humans; Medical disciplines: 700; Medisinske Fag: 700; Motor Activity; Myocardial Infarction - diagnosis; Myocardial Infarction - epidemiology; Risk Factors; VDP
• ISSN: 2047-4873; 2047-4881; 2047-4881
• DOI: 10.1093/eurjpc/zwaa146

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. 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 (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%). A moderate-to-high level of PA was associated with a lower risk of instant and 28-day death in relation to a MI.