Level of Physical Activity and In-Hospital Course of Patients with Acute Coronary Syndrome

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Acute Coronary Syndrome (n=215). Intervention: Physically active lifestyle vs. Non-active lifestyle. Primary outcome: In-hospital cardiovascular events (OR 2.54 (for non-active vs active), 95% CI 1.24-5.20, p=0.01).

Juliana de Góes Jorge; Marcos Antônio Almeida Santos; José Augusto Soares Barreto-Filho; Joselina Luzia Menezes Oliveira; Enaldo Vieira de Melo; Norma Alves de Oliveira; Gustavo Baptista de Almeida Faro; Antônio Carlos Sobral Sousa

doi:10.5935/abc.20160006

November 19, 2015Arquivos Brasileiros de CardiologiaOpen Access

Level of Physical Activity and In-Hospital Course of Patients with Acute Coronary Syndrome

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Key result

Physical inactivity links to ~154% higher odds of in-hospital CV events among ACS patients.

OR 2.54 (for non-active vs active)
95% CI 1.24-5.20
P=0.01
n=215

Why the study?

Does a physically active lifestyle prior to admission reduce in-hospital cardiovascular events in patients with acute coronary syndrome?

Study Design

Type

Cross-Sectional (n=215)

Multicenter

No

Structured PICO

Does a physically active lifestyle prior to admission reduce in-hospital cardiovascular events in patients with acute coronary syndrome?

P

Population

215 subjects with a diagnosis of acute coronary syndrome (unstable angina, non-STEMI, or STEMI) consecutively admitted to a referral hospital for cardiac patients in Sergipe, Brazil. Mean age 66.5 years, 57.7% male.

I

Intervention

Physically active lifestyle prior to admission (classified as active or very active according to the short version of the International Physical Activity Questionnaire [IPAQ])

C

Comparator

Physically inactive lifestyle prior to admission (classified as sedentary or irregularly active according to the short version of the IPAQ)

O

Outcome

Occurrence of cardiovascular events (CVE) during hospitalization (composite of cardiovascular death, recurrent ischemic events, acute pulmonary edema, stroke, cardiogenic shock, and atrial fibrillation)composite

Main Result

Effect estimate: OR 2.54 (for non-active vs active) (95% CI 1.24-5.20)

Absolute Event Rate: 21.3% vs 46.3%

p-value: p=0.01

Limitations

The IPAQ adopts an indirect methodology to assess physical activity and is subject to flaws.
The population was composed exclusively of beneficiaries of supplementary health insurance.
The cohort was recruited from a single center.
The observational design cannot establish causality (reverse causality is possible).
Did not evaluate the frequency of complications in different strata of physical activity levels

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Implication

A physically active lifestyle prior to admission is associated with a significantly lower risk of in-hospital cardiovascular complications in patients presenting with acute coronary syndrome.

Abstract

BACKGROUND: Acute coronary syndrome (ACS) is one of the main causes of morbidity and mortality in the modern world. A sedentary lifestyle, present in 85% of the Brazilian population, is considered a risk factor for the development of coronary artery disease. However, the correlation of a sedentary lifestyle with cardiovascular events (CVE) during hospitalization for ACS is not well established. OBJECTIVE: To evaluate the association between physical activity level, assessed with the International Physical Activity Questionnaire (IPAQ), with in-hospital prognosis in patients with ACS. METHODS: Observational, cross-sectional, and analytical study with 215 subjects with a diagnosis of ACS consecutively admitted to a referral hospital for cardiac patients between July 2009 and February 2011. All volunteers answered the short version of the IPAQ and were observed for the occurrence of CVE during hospitalization with a standardized assessment conducted by the researcher and corroborated by data from medical records. RESULTS: The patients were admitted with diagnoses of unstable angina (34.4%), acute myocardial infarction (AMI) without ST elevation (41.4%), and AMI with ST elevation (24.2%). According to the level of physical activity, the patients were classified as non-active (56.3%) and active (43.7%). A CVE occurred in 35.3% of the cohort. The occurrence of in-hospital complications was associated with the length of hospital stay (odds ratio [OR] = 1.15) and physical inactivity (OR = 2.54), and was independent of age, systolic blood pressure, and prior congestive heart failure. CONCLUSION: A physically active lifestyle reduces the risk of CVE during hospitalization in patients with ACS.

Discussion

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Cite This Study

Jorge et al. (2015) conducted a cross-sectional in Acute Coronary Syndrome (n=215). Physically active lifestyle vs. Non-active lifestyle was evaluated on In-hospital cardiovascular events (OR 2.54 (for non-active vs active), 95% CI 1.24-5.20, p=0.01). A physically inactive lifestyle was associated with a 2.54-fold increased odds of in-hospital cardiovascular events compared to an active lifestyle in patients with acute coronary syndrome.

synapsesocial.com/papers/6a0a3ae441a1eeaa0645b61b https://doi.org/10.5935/abc.20160006

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Level of Physical Activity and In-Hospital Course of Patients with Acute Coronary Syndrome

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Level of Physical Activity and In-Hospital Course of Patients with Acute Coronary Syndrome

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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