Association between exercise habits and stroke, heart failure, and mortality in Korean patients with incident atrial fibrillation: A nationwide population-based cohort study
Key result
Starting exercise after a new AF diagnosis is linked to ~5% lower heart failure risk.
- HR 0.95
- 95% CI 0.90-0.99
- P<0.001
- n=66,692
Why the study?
There is a paucity of information regarding cardiovascular outcomes related to exercise habit changes after a new diagnosis of AF.
Does initiating or continuing regular exercise reduce the risk of ischemic stroke, heart failure, and mortality in patients with newly diagnosed atrial fibrillation?
Population
66,692 patients with newly diagnosed AF in Korea
Comparison
Persistent non-exercisers vs new exercisers vs exercise dropouts vs exercise maintainers
Design
Nationwide population-based retrospective cohort study
Follow-up
Mean 3.4 ± 2.0 years
Authors
Discussion
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Member takes
Implication
May support exercise counseling post-AF diagnosis; leaves open whether RCTs confirm causal HF risk reduction.
Study Design
Type
Cohort (n=66,692)
Multicenter
Yes
Structured PICO
Does initiating or continuing regular exercise reduce the risk of ischemic stroke, heart failure, and mortality in patients with newly diagnosed atrial fibrillation?
P
Population
66,692 Korean patients with newly diagnosed atrial fibrillation (AF) between 2010 and 2016 who underwent 2 serial health examinations within 2 years before and after their AF diagnosis
I
Intervention
Initiating or continuing regular exercise after AF diagnosis (categorized as new exercisers, exercise maintainers, or exercise dropouts based on self-reported questionnaires)
C
Comparator
Persistent non-exercisers
O
Outcome
Incidence of ischemic stroke, heart failure (HF), and all-cause deathhard clinical
Main Result
Effect estimate: HR 0.95 (95% CI 0.90-0.99)
p-value: p=<0.001
Initiating or maintaining regular exercise after a new diagnosis of atrial fibrillation is associated with significantly lower risks of heart failure and all-cause mortality.
Limitations
- Recall bias introduced due to the nature of the self-reported questionnaire
- Restricted external generalizability to other ethnic groups
- recall bias introduced due to the nature of the self-reported questionnaire
- restricted external generalizability to other ethnic groups
Cite This Study
Ahn et al. (2021) conducted a cohort in incident atrial fibrillation (n=66,692). Regular exercise (new exercisers, maintainers, dropouts) vs. Persistent non-exercisers was evaluated on incidence of ischemic stroke, heart failure, and all-cause death (HR 0.95, 95% CI 0.90-0.99, p=<0.001). Initiating regular exercise after a new atrial fibrillation diagnosis was associated with a lower risk of heart failure (HR 0.95; 95% CI 0.90-0.99; p<0.001) compared to persistent non-exercising.