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La actividad física de alto volumen y los resultados clínicos de la enfermedad arterial coronaria: hallazgos del
Jarett D Berry1,2, Noor Zabad1, Douglas Kyrouac2
1Department of Internal Medicine, University of Texas at Tyler School of Medicine (J.D.B., N.Z.).
Circulation
|April 21, 2025
Resumen
La actividad física de alto volumen (AP) reduce el riesgo de mortalidad por cualquier causa, pero no reduce los eventos de enfermedad coronaria clínica (CAD). El calcio de la arteria coronaria (CAC) aumenta el riesgo de CAD independientemente del volumen de ejercicio.
Área de la Ciencia:
- Cardiología
- Fisiología del ejercicio
- La medicina preventiva
Sus antecedentes:
- La actividad física de alto volumen (AP) está relacionada con el aumento de la enfermedad coronaria subclínica (CAD).
- El impacto clínico de la ECA subclínica en atletas y la relación dosis-respuesta de la AP en los eventos de ECA no se comprenden completamente.
Objetivo del estudio:
- Investigar la asociación entre volúmenes variables de PA, CAD subclínica y eventos clínicos de CAD.
- Determinar si la CAD subclínica modifica la relación entre la AP y los resultados clínicos.
Principales métodos:
- Se utilizaron datos del Estudio Longitudinal del Centro Cooper (1987-2018) vinculados a las reclamaciones de Medicare.
- Volumen de PA categorizado (MET-minutos/semana) y CAD subclínico evaluado a través de la puntuación de calcio de la arteria coronaria (CAC).
- Se empleó el análisis de supervivencia para evaluar las asociaciones entre PA, CAC y eventos CAD compuestos (infarto de miocardio, revascularización) o mortalidad por cualquier causa.
Principales resultados:
- Los volúmenes de PA intermedios (de 500 a 2999 MET-minutos/ semana) se asociaron con el riesgo más bajo de infarto agudo de miocardio.
- El alto volumen de PA (≥3000 MET-minutos/semana) no mostró una asociación significativa con el riesgo de infarto agudo de miocardio, pero se relacionó con una menor mortalidad por cualquier causa.
- El CAC fue un predictor consistente de eventos CAD compuestos en todos los niveles de PA, sin que se detectara una interacción significativa.
Conclusiones:
- El alto volumen de PA se asocia con una reducción de la mortalidad por cualquier causa, pero no necesariamente una reducción del riesgo de eventos clínicos de CAD.
- La CAD subclínica, indicada por el CAC, plantea un mayor riesgo de eventos clínicos de CAD independientemente del volumen de PA de un individuo.
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