An investigation of in excess of 15,000 people recommends customary actual work might assist with forestalling the improvement of atrial fibrillation, as well as the frequency of stroke and MACE.

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Exercise Capacity Shows Inverse Correlation with Atrial Fibrillation and Stroke Risk, Study Finds
Study presented at the European Society of Cardiology Congress 2023 highlights the link between fitness levels and cardiovascular health.

A groundbreaking study, unveiled at the European Society of Cardiology (ESC) Congress 2023, has unveiled a significant association between exercise capacity and the incidence of atrial fibrillation (AF) and stroke. The research, based on the analysis of over 15,000 patients, suggests that better exercise performance is tied to a lower risk of AF, ischemic stroke, and major adverse cardiovascular events (MACE).

Dr. Shih-Hsien Sung, MD, PhD, from National Yang-Ming Chiao Tung University in Taiwan, who led the study, described it as a substantial endeavor with objective fitness measurements and over 11 years of follow-up. The findings underscore the potential preventive effects of maintaining good fitness levels against atrial fibrillation and stroke.

Atrial fibrillation, a common heart rhythm disorder affecting more than 40 million people globally, is linked to an increased risk of various cardiovascular issues, compromised quality of life, elevated mortality rates, and substantial health expenditures. Those diagnosed with AF face a five-fold higher risk of stroke compared to individuals without the condition.

While multiple cardiovascular risk factors contribute to the development of AF, lifestyle factors such as regular exercise and robust cardiorespiratory fitness can play a pivotal role in modifying these risk factors and reducing the incidence of AF. Dr. Sung and the research team sought to investigate the relationship between exercise performance and the risk of incident atrial fibrillation, as well as associated comorbidities.

The retrospective study, conducted from 2003 to 2012, included 19,680 patients with no prior diagnosis of AF who underwent exercise treadmill testing. The researchers meticulously analyzed baseline characteristics and exercise parameters during testing for all participants.
Utilizing multivariable Cox proportional hazards models, the investigators delved into the independent correlation between exercise performance and the risk of new-onset AF, ischemic stroke, and MACE. The analysis accounted for confounding factors such as age, sex, cholesterol levels, kidney function, prior stroke, hypertension, and medication usage. A cubic spline regression model was employed to gauge the risk of new-onset AF across different fitness levels.

The study encompassed 15,450 participants, with an average age of 54.9 years, and over half of them (59%) being male. Over a median follow-up period of 137 months, the researchers identified 515 cases (3.33%) of new-onset AF.

Remarkably, every 1 peak metabolic equivalent (MET) increase achieved during exercise treadmill testing correlated with an 8% lower risk of AF incidence, a 12% reduced risk of ischemic stroke, and a 14% lower risk of MACE, even after accounting for confounding factors.

Participants were categorized into three fitness levels based on METs achieved during the treadmill test: low (less than 8.57 METs), medium (8.57 to 10.72), and high (more than 10.72). The probability of remaining free from atrial fibrillation over a 5-year period was 97.1%, 98.4%, and 98.4% in the low, medium, and high fitness groups, respectively.

Subgroup analyses revealed that peak achieved METs during exercise testing exhibited significant associations with the risk of new-onset AF across different subgroups, including age, body mass index, and underlying diseases.

Dr. Sung and colleagues emphasize the need for further research to unravel the underlying mechanisms that connect exercise capacity with AF incidence.

References:


CT Lu, SH Sung. Exercise performance and the risk of incident atrial fibrillation. Presented at the European Society of Cardiology Congress 2023. Amsterdam, the Netherlands. August 25-August 28.
Escardio. Keep fit to avoid heart rhythm disorder and stroke. EurekAlert! August 22, 2023. Accessed August 22, 2023. Link.

Kornej J, Börschel CS, Benjamin EJ, Schnabel RB. Epidemiology of Atrial Fibrillation in the 21st Century: Novel Methods and New Insights. Circ Res. 2020;127(1):4-20. doi:10.1161/CIRCRESAHA.120.316340