Associations between physical activity and cardiorespiratory fitness and adverse outcomes in patients with atrial fibrillation: a prospective cohort study

Figures

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  Figure 1. Flowchart of population screening in this study. PA, physical activity; CRF, cardiorespiratory fitness.

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  Figure 2. Forest plot of the associations between different intensities of PA and the risk of incident outcomes. Cox proportional hazard model adjusted for age at the time of wearing the accelerometer device, sex, ethnicity, education level, Townsend deprivation index stage, alcohol assumption status, smoking status, diet quality level, history of cardiovascular disease, and self-report medication intake, including cholesterol-lowering drugs, blood pressure, or insulin. HR, hazard ratio; CI, confidence interval; TPA, total physical activity; MVPA, moderate-to-vigorous physical activity; LPA, light physical activity; MPA, moderate physical activity; VPA, vigorous physical activity.

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  Figure 3. Trend of the association between PA and cardiovascular adverse outcomes. Different intensities of PA were stratified by the quartiles of PA volume, with Q1 as the reference group. Panel (A–C) represent MACE, cardiovascular death, and MI, respectively. The Cox regression adjusted for age, sex, ethnicity, education, Townsend deprivation index, smoking status, alcohol consumption status, diet quality level, blood pressure, history of cardiovascular disease, and self-report medication intake, including cholesterol-lowering drugs, blood pressure, or insulin. The general association trends between PA and the outcomes were tested and P < 0.05 was deemed statistically significant. MACE, major adverse cardiovascular events; MI, myocardial infarction; TPA, total physical activity; MVPA, moderate-to-vigorous-intensity physical activity; LPA, light-intensity physical activity; MPA, moderate-intensity physical activity; VPA, vigorous-intensity physical activity; Q, quartile.

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  Figure 4. Dose–response associations between PA and cardiovascular adverse outcomes. The Cox regression models with restricted cubic splines were used to explore the dose–response relationship between PA and the outcomes. The HRs and their 95% CIs were calculated. All were adjusted for age, sex, ethnicity, education, Townsend deprivation index, smoking status, alcohol consumption status, diet quality level, blood pressure, history of cardiovascular disease, and self-report medication intake, including cholesterol-lowering drugs, blood pressure, or insulin. MACE, major adverse cardiovascular event; MI, myocardial infarction; TPA, total physical activity; MVPA, moderate-to-vigorous-intensity physical activity; LPA, light-intensity physical activity; MPA, moderate-intensity physical activity; VPA, vigorous-intensity physical activity.

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  Figure 5. Dose–response associations between CRF and the risk of incident outcomes. The Cox regression models with restricted cubic splines were used to explore the dose–response relationship between cardiorespiratory fitness and the outcomes. The HRs and their 95% CIs are shown. The Cox proportional hazard models were adjusted for age, sex, ethnicity, education, Townsend deprivation index, smoking status, alcohol consumption, diet quality, blood pressure, waist-to-hip ratio, body mass index, parental history of cardiovascular disease, and personal history of antihypertensive, lipid-lowering, or glucose-lowering medication use. HR, hazard ratio; CI, confidence interval; AF, atrial fibrillation; HF, heart failure.