Do heart failure status and psychosocial variables moderate the relationship between leisure time physical activity and mortality risk among patients with a history of myocardial infarction?

Rony Oosterom-Calo,Yaacov Drory,Saskia J Te Velde,Johannes Brug,Yariv Gerber,Wim Stut

doi:10.1186/s12872-016-0363-7

Abstract

BackgroundLeisure time physical activity (LTPA) is inversely related to mortality risk among patients with a history of myocardial infarction (MI). The aims were to explore if heart failure (HF) status and psychosocial variables moderate the association.MethodsParticipants (n = 1169) were from a multi-center prospective cohort study. Information on LTPA (none, irregular,1–150, 151–300 and >300 weekly minutes), depression, social support and other prognostic indicators were collected 10–13 years after index MI. Cox regressions were conducted, adjusting for potential confounders. In case of significant moderation by HF-status or psychosocial variables, stratified analyses were performed.ResultsDuring follow-up (M = 8.4 years), 25.6 % of the sample had died. LTPA was inversely associated with mortality (p for trend < 0.01 in all models). HF did not, but psychosocial variables did, moderate the association. In the LTPA category 1–150 weekly minutes, patients with a high level of depression had a lower mortality risk in comparison to those with a low level (hazard ratios (95 % confidence intervals) were 0.43 (0.25, 0.75) versus 0.69 (0.36, 1.32)), and patients with a low level of social support had a lower mortality risk in comparison to those with a high level (0.40 (0.21, 0.77) versus 0.71 (0.39, 1.27)). In the category >300 min, patients with a high level of social support had a lower mortality risk than those with a low level (0.38 (0.19, 0.79) versus 0.51 (0.30, 0.87)).ConclusionsLTPA was inversely related to mortality risk of post-MI patients. HF did not moderate the relationship; depression and social support partially did.Electronic supplementary materialThe online version of this article (doi:10.1186/s12872-016-0363-7) contains supplementary material, which is available to authorized users.

Highlights

Leisure time physical activity (LTPA) is inversely related to mortality risk among patients with a history of myocardial infarction (MI)
Building on the previous work, in the current work we explore differences in mortality risk based on the number of regular weekly LTPA minutes by refining the category of regular weekly LTPA to include more categories, in order to understand if patients who performed more regular LTPA had a lower mortality risk than those who performed less regular LTPA
Heart failure (HF) may be an important modifier of the relationship between performance of LTPA and mortality risk, because on the one had post-MI heart failure (HF) patients have worse prognosis [6] compared to patients who did not develop HF [7], Physical activity (PA) performance may be a protective factor among HF patients by reducing the risk of cardiovascular events and mortality [8]

Summary

Introduction

Leisure time physical activity (LTPA) is inversely related to mortality risk among patients with a history of myocardial infarction (MI). Physical activity is defined as any bodily movement produced by contraction of skeletal muscles resulting in energy expenditure above the basal level [1]. Heart failure (HF) may be an important modifier of the relationship between performance of LTPA and mortality risk, because on the one had post-MI HF patients have worse prognosis [6] compared to patients who did not develop HF [7], PA performance may be a protective factor among HF patients by reducing the risk of cardiovascular events and mortality [8]. The first aim of the current work is to assess whether HF is a modifying factor in the relationship between LTPA and mortality risk

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