Increased exercise is associated with reduced mortality risk in AFib patients
A new cohort of European patients Atrial Fibrillation (AFib) Demonstrate the benefits of physical activity in reducing the risk of all-cause mortality and overall mortality.
A research team led by Marco Vitolo, MD, from various European institutions, evaluated more than 8,000 patients with AFib and interpreted the association between physical activity and mortality outcomes in a cardiovascularly burdened population.
The findings were presented this weekend at the European Society of Cardiology (ESC) 2020 conference.
Vitolo of the University of Modena and the University of Reggio Emilia in Italy led the analysis of AFib patients previously enrolled in the ESC-European Heart Rhythm Association EURObservational Atrial Fibrillation (ESC-EHRA EORP-AF) General Long-Term Registry.
When assessing a large cohort of patients with Registry AFib, the team needed to correlate impacts on all-cause mortality risk based on the physical activity metrics reported by the patients. Physical activity was stratified based on the time reported to be exercised. Irregular activities; regular activities; and intense activities. Investigators sought major consequences of all-cause mortality.
Of over 11,000 available enrolled patients, 8699 had available data on AFib diagnosis and physical activity. The average age of patients was 69.1 years, and 40.7% were female. The team included follow-up observational data in their analysis.
Patients clearly reported no physical activity (42.6%). Another 32.5% reported irregular physical activity and 21.0% regular activity. Just 343 patients (3.9%) reported intense physical activity.
Vitolo and colleagues observe progressively lower metrics of female patient proportion, mean age, AFib stroke risk and major bleeding risk (CHA2DS2 and HAS-BLED, respectively) among increasing categories of physical activity Did(P <.001 for all).
Vitamin K antagonist use was also shown to decrease across increasing classes of physical activity: 53.1%; 52.2%; 44.5%; each 33.9% (P <.001). Conversely, non-vitamin K OAC (NOAC) has increased use across classes.
Investigators observed 848 (9.7%) all-cause events with an average follow-up of 680.6 days. Based on an analysis by Kaplan-Meier, they observed a gradual reduction in the cumulative risk of all-cause mortality based on physical activity levels.
Using multivariate Cox regression analysis, CHA2DS2, use of OAC at baseline, and AFib type (HR, 0.69; 95% CI, .59-.81 for occasional activity, HR 0.45, usually 95% CI, .35-.58 for active activity, HR, 0.41, 95% CI, .23-.76 for intense activity, all vs active.
Vitolo and colleagues found in a sensitivity analysis that regular and intense physical activity levels were inversely related to cardiovascular mortality risk and were associated with multivariable adjustments for comorbidities (HR, 0.54; 95% CI, .37). -.77).
“Self-reported in a large contemporary cohort of European AFib patients [physical activity] They were found to be inversely proportional to all-cause mortality and CV mortality.”
the study, “Impact of physical activity on all-cause mortality in patients with atrial fibrillation in Europe: Report from ESC-EHRA EORP AF General Long-Term RegistryWas announced at ESC 2020.
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