Regular exercise after a diagnosis of atrial fibrillation and lower risks of cardiovascular disease: a nationwide population-based study. (25th November 2020)

• Record Type: Journal Article
• Authors: Ahn, H.J; Lee, S.R; Choi, E.K; Han, K.D; Jung, J.H; Lim, J.H; Yun, J.P; Lee, E.J; Cha, M.J; Oh, S; Lip, G.Y.H
• Is Part Of: European heart journal. Volume 41:(2020)Supplement 2
• Publication Date: 2020-11-25
• Subjects: Prevention: Exercise; Cardiology -- Periodicals; Heart -- Diseases -- Periodicals; 616.12005
• DOI: 10.1093/ehjci/ehaa946.2873
• Languages: English
• ISSNs: 0195-668X

Abstract

Abstract: Introduction: There is a paucity of information about cardiovascular impacts related to the change of exercise habit after a new diagnosis of atrial fibrillation (AF). We aimed to investigate the influence of exercise on the risk of cardiovascular outcomes, such as ischemic stroke, heart failure (HF), and all-cause death, in patients with AF. Methods: We included 66, 692 patients with newly diagnosed AF (36.4% female, mean age 59.5 years, mean CHA2DS2-VASc 1.9) who underwent two serial health examinations before and after diagnosis of AF from 2010 to 2016, as provided by Korean National Health Insurance Corporation. The individuals self-reported a degree and frequency of exercise by questionnaires and doing vigorous physical activities ≥3 times/week or moderate physical activities ≥5 times/week was defined as a regular exercise group. The study population was divided into four categories according to the status of regular exercise before and after AF diagnosis: persistent non-exerciser (64.0%), new exerciser (13.4%), exercise drop-outs (12.5%), and exercise maintainer (10.1%). The primary outcomes were ischemic stroke, HF, and all-cause death during the follow-up. Results: During a median 3.4 years follow-up, ischemic stroke, HF, and all-cause death occurred in 1905, 13112, and 2627 patients, respectively (incidence rates 8.5, 64.8, and 11.5 per 1, 000 person-years, respectively). The change in exercise habits did not have a significant association with the risk of ischemic stroke (Figure 1). Regarding HF, those who newly initiated or maintained exercise after AF diagnosis showed a lower risk than those who do not exercise: hazard ratio, HR 0.93; 95% confidence interval, CI [0.88 to 0.98] and 0.90 [0.85 to 0.96] for each group, all p<0.001. Any experience of exercise involvement was associated with a lower risk of mortality than those without exercise: HR 0.76 [0.68–0.87] for new exerciser, 0.87 [0.78–0.98] for exercise drop-outs, and 0.62 [0.53–0.73] for exercise maintainer, all p<0.0001. Conclusions: Patients who started or continued exercising after a new diagnosis of AF showed a lower risk of HF and mortality, but did not show an association with ischemic stroke. Regular exercise might improve the cardiovascular outcomes in patients with newly diagnosed AF. Funding Acknowledgement: Type of funding source: None