Barons, Martine J., Turner, Sally, Parsons, Nicholas R., Griffiths, Frances, Bethell, Hugh, Weich, Scott and Thorogood, Margaret (2015) Fitness predicts long-term survival after a cardiovascular event : a prospective cohort study. BMJ Open, 5 (10). e007772. doi:10.1136/bmjopen-2015-007772 ISSN 2044-6055.

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Abstract

Objectives:
To identify the role of fitness, fitness change, body mass index and other factors in predicting long-term (>5 years) survival in patients with coronary heart disease.

Design:
Cohort study of patients with coronary heart disease recruited from 1 January 1993 to 31 December 2002, followed up to March 2011 (1 day to 18 years 3 months, mean 10.7 years).

Setting:
A community-based National Health Service (NHS) cardiac rehabilitation programme serving the Basingstoke and Alton area in Hampshire, UK. Participants: An unselected cohort of NHS patients, 2167 men and 547 women aged 28–88 years, who attended the rehabilitation programme following acute myocardial infarction, an episode of angina or revascularisation, and had a baseline fitness test. Main outcome measures: Cardiovascular mortality and all-cause mortality.

Results:
A high level of fitness (VO2≥22 mL/kg/min for men, VO2≥19 mL/kg/min for women) at completion of the programme was associated with decreased all cause death, as was a prescription for statins or aspirin, and female gender. Increase in all-cause mortality was associated with higher age and ACE inhibitors prescription. Higher risk of cardiovascular mortality was associated with increasing age, prescriptions for ACE inhibitor, and diagnosis of myocardial infarction or angina as compared with the other diagnoses.

Conclusions:
Prior fitness and fitness improvement are strong predictors of long-term survival in patients who have experienced a cardiac event or procedure. Some secondary prevention medications make a significant contribution to reducing all-cause mortality and cardiovascular mortality in these patients. This study supports public health messages promoting fitness for life.

Item Type:	Journal Article
Subjects:	R Medicine > RC Internal medicine
Divisions:	Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Social Science & Systems in Health (SSSH) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Cardiovascular fitness, Cardiac intensive care
Journal or Publication Title:	BMJ Open
Publisher:	BMJ
ISSN:	2044-6055
Official Date:	22 October 2015
Dates:	Date Event 22 October 2015 Published 15 July 2015 Accepted 23 January 2015 Submitted
Volume:	5
Number:	10
Article Number:	e007772
DOI:	10.1136/bmjopen-2015-007772
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access
Date of first compliant deposit:	30 December 2015
Date of first compliant Open Access:	30 December 2015
RIOXX Funder/Project Grant:	Project/Grant ID RIOXX Funder Name Funder ID A.PXCX.0001 [EPSRC] Engineering and Physical Sciences Research Council http://dx.doi.org/10.13039/501100000266 UNSPECIFIED Chartered Society of Physiotherapy Charitable Trust http://dx.doi.org/10.13039/100011698 UNSPECIFIED Basingstoke and Alton Cardiac Rehabilitation Charity Ltd. UNSPECIFIED
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