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Physical inactivity and smoking after myocardial infarction as predictors for readmission and survival: results from the SWEDEHEART-registry.
Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology. Karolinska University Hospital.ORCID iD: 0000-0001-9833-8306
Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.ORCID iD: 0000-0001-6058-4982 
Falun Hospital.
Gothenburg University and Sahlgrenska University Hospital.
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2019 (English)In: Clinical Research in Cardiology, ISSN 1861-0684, E-ISSN 1861-0692, Vol. 108, no 3, p. 324-332Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Physical activity (PA) and smoking cessation are included in the secondary prevention guidelines after myocardial infarction (MI), but they are still underutilised. This study aims to explore how PA level and smoking status (6-10 weeks post-MI) were associated with 1-year readmission and mortality during full follow-up time, and with the cumulative 5-year mortality.

METHODS: A population-based cohort of all hospitals providing MI-care in Sweden (SWEDEHEART-registry) in 2004-2014. PA was expressed as the number of exercise sessions of ≥ 30 min in the last 7 days: 0-1 (low), 2-4 (medium) and 5-7 (high) sessions/week. Individuals were categorised as smokers, former smokers or never-smokers. The associations were analysed by unadjusted and adjusted logistic and Cox regressions.

RESULTS: During follow-up (M = 3.58 years), a total of 1702 deaths occurred among 30 644 individuals (14.1 cases per 1000 person-years). For medium and high PA, the hazard ratios (HRs) for mortality were 0.39 and 0.36, respectively, compared with low PA. For never-smokers, the HR was 0.45 and former smokers 0.56 compared with smokers. Compared with low PA, the odds ratios (ORs) for readmission in medium PA were 0.65 and 0.59 for CVD and non-CVD causes, respectively. For high PA, the corresponding ORs were 0.63 and 0.55. The association remained in adjusted models. There were no associations between smoking status and readmission.

CONCLUSIONS: The PA level and smoking status are strong predictors of mortality post-MI and the PA level also predicts readmission, highlighting the importance of adherence to the secondary prevention guidelines.

Place, publisher, year, edition, pages
Springer, 2019. Vol. 108, no 3, p. 324-332
Keywords [en]
Hospitalisation, Myocardial ischaemia, Physical activity, Survival, Tobacco
National Category
Cardiac and Cardiovascular Systems
Research subject
Medicine/Technology
Identifiers
URN: urn:nbn:se:gih:diva-5405DOI: 10.1007/s00392-018-1360-xISI: 000459158700012PubMedID: 30167806OAI: oai:DiVA.org:gih-5405DiVA, id: diva2:1245027
Available from: 2018-09-04 Created: 2018-09-04 Last updated: 2019-03-21

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Ek, AmandaEkblom, ÖrjanKallings, Lena

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