Fitness predicts long-term survival after a cardiovascular event: a prospective cohort study

Area of Science:

• Cardiology
• Preventive Medicine
• Public Health

Background:

• Coronary heart disease (CHD) poses a significant long-term survival challenge.
• Cardiac rehabilitation programs aim to improve outcomes for patients post-cardiac events.
• Predictors of long-term survival in CHD patients require further investigation.

Purpose of the Study:

• To determine the predictive role of fitness, fitness changes, and body mass index on long-term survival (>5 years) in CHD patients.
• To identify other contributing factors influencing survival in this cohort.

Main Methods:

• A prospective cohort study was conducted involving 2714 patients (2167 men, 547 women) aged 28-88 years attending a UK National Health Service cardiac rehabilitation program.
• Participants were recruited between January 1993 and December 2002 and followed up until March 2011 (mean follow-up 10.7 years).
• Baseline fitness was assessed, and cardiovascular and all-cause mortality were recorded as primary outcomes.

Main Results:

• High fitness levels (VO2≥22 mL/kg/min for men, VO2≥19 mL/kg/min for women) at program completion were associated with reduced all-cause mortality.
• Prescription of statins or aspirin and female gender were also linked to decreased all-cause death.
• Increased age and ACE inhibitor prescription were associated with higher all-cause mortality, while increasing age, ACE inhibitor prescription, and diagnoses of myocardial infarction or angina increased cardiovascular mortality risk.

Conclusions:

• Both baseline fitness and improvements in fitness are powerful predictors of long-term survival in patients with a history of cardiac events.
• Secondary prevention medications, including statins and aspirin, play a crucial role in reducing mortality.
• The findings underscore the importance of promoting lifelong fitness for individuals with coronary heart disease.