Implantable device measured objective daily physical activity as a predictor of long-term all-cause mortality and cardiac death in patients with age\u2009>\u200975\u2009years and high risk of sudden cardiac death: a cohort study

Xiaoyao Li,Zeyi Li,Jiefu Yang,Wei Hua,Zhaoguang Liang,Keping Chen,Shuang Zhao,Shu Zhang,Yangang Su,Wei Xu

doi:10.1186/s12877-022-02813-1

Abstract

BackgroundTo study the relationship between objective daily physical activity (PA), as measured by implantable cardioverter defibrillators (ICDs)/cardiac resynchronization therapy defibrillators (CRTDs), and long-term prognoses in patients with age > 75 years at high risk of sudden cardiac death (SCD).MethodsIn total, 133 patients with age > 75 years old (age 79.52 ± 3.68 years) in the SUMMIT study were retrospectively analysed. The major endpoint was all-cause mortality, and the minor endpoint was cardiac death.ResultsThe mean follow-up time was 57.1 ± 24.2 months (range: from 4 to 96 months). In total, 46 all-cause mortality and 23 cardiac death events occurred. The receiver operating characteristic curve indicated a baseline PA cut-off value of 6.47% (93 min/day) can predict all-cause mortality in patients with age > 75 years, with an area under the curve of 0.670 (95% confidence interval (CI): 0.573–0.767, P = 0.001). The sensitivity was 67.4%, and the specificity was 66.7%. Patients with baseline PA ≤ 6.47% had higher rates of all-cause mortality (51.7% vs 20.5%, P < 0.001) and cardiac death (25.0% vs 11.0%, P = 0.040). The estimated Kaplan-Meier survival curves showed that patients with PA ≤ 6.47% had an increased cumulative incidence of all-cause mortality (Log-rank P < 0.0001) and cardiac death (Log-rank P = 0.0067). Multivariate Cox regression analysis showed that PA ≤ 6.47% was an independent predictor of all-cause mortality (hazard ratio (HR) 3.137, 95% CI: 1.667–5.904, P < 0.001) and cardiac death (HR value 3.345, 95% CI: 1.394–8.028, P = 0.007).ConclusionsDaily PA of about 1.5 h was associated with lower all-cause mortality and cardiac death risk in patients with age > 75 years and high risk of SCD with ICDs/CRTDs. PA monitoring may aid in long-term management of older patients at high risk of SCD.

Highlights

To study the relationship between objective daily physical activity (PA), as measured by implantable cardioverter defibrillators (ICDs)/cardiac resynchronization therapy defibrillators (CRTDs), and long-term prognoses in patients with age > 75 years at high risk of sudden cardiac death (SCD)
Daily PA of about 1.5 h was associated with lower all-cause mortality and cardiac death risk in patients with age > 75 years and high risk of SCD with ICDs/CRTDs
Baseline characteristics In total, 133 patients over 75 years old with ICDs/CRTDs were included in the present study

Summary

Introduction

To study the relationship between objective daily physical activity (PA), as measured by implantable cardioverter defibrillators (ICDs)/cardiac resynchronization therapy defibrillators (CRTDs), and long-term prognoses in patients with age > 75 years at high risk of sudden cardiac death (SCD). Cardiovascular disease has been the major cause of mortality in older people [2]. Sudden cardiac death (SCD), as a serious public health problem worldwide, accounts for virtually half of all cardiovascular deaths [3]. A number of studies indicate physical activity (PA) is related to many chronic diseases, premature mortality, and poor cardiovascular prognoses [5, 6]. For older people in particular, physical activities are often limited. Survey results have shown that a low proportion of patients, especially older patients, perform the recommended amount of PA [7, 8]

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