Abstract 2049: Self-reported Leisure-time Physical Activity Predicts Long-term Survival in Patients with Coronary Heart Disease
Background and Objectives: Self-reported leisure-time physical activity level is an independent predictor of cardiovascular (CV) and non-CV mortality in individuals without coronary heart disease (CHD). The impact of leisure-time physical activity on long-term outcomes has not been studied in details in individuals with pre-existing CHD who are often physically limited due to symptomatology, medications, and comorbid conditions. Our objective was to determine the long-term prognostic value of self-reported leisure-time physical activity in a large cohort of individuals with stable chronic CHD.
Methods: We identified 14,021 patients with baseline leisure-time physical activity data from the CASS registry database. Leisure-time physical activity was evaluated using a self-administered questionnaire and categorized using a 4-level scale (sedentary, mild, moderate, strenuous). Long-term all-cause and cardiovascular mortality were analyzed according to physical activity level and adjusted for potential confounders. Intermediate-term (5-year follow-up) combined morbidity and mortality was also assessed according to physical activity level.
Results: Median long-term follow-up was 14.7 years (Inter Quartile Range: 9.8 to 16.2). Long-term all-cause and CV mortality progressively increased from most to least active individuals, with sedentary patients showing a 1.6-fold increase in mortality for both outcomes (hazard ratio=1.63; 95% CI 1.34 –1.97, P<0.0001 for all-cause mortality). Sedentary patients showed a 2-fold increased risk for the combined endpoint of all-cause death or hospitalization for incident myocardial infarction, stroke or congestive heart failure (hazard ratio=2.03; 95% CI 1.55–2.65, P<0.0001). Similar trends were noted for men and women, those treated medically or surgically, and in adjusted models although hazard ratios were attenuated after adjustment.
Conclusions: Leisure-time physical activity independently predicts long-term survival in male and female patients with chronic stable CHD. The findings of our study confirm the results of previous small studies, but in a significantly larger cohort, with a significantly longer follow-up period and we extend our results to women.