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


METHODS
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).


METHODS
A community-based National Health Service (NHS) cardiac rehabilitation programme serving the Basingstoke and Alton area in Hampshire, UK.


METHODS
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.


METHODS
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.
Complexity Science Centre, University of Warwick, Coventry, UK.
Martine J
MJ
Barons
Basingstoke Cardiac Rehabilitation Centre, Basingstoke, UK.
Sally
S
Turner
Warwick Medical School, University of Warwick, Coventry, UK.
Nicholas
N
Parsons
Warwick Medical School, University of Warwick, Coventry, UK.
Frances
F
Griffiths
Basingstoke & Alton Cardiac Rehabilitation Centre, Basingstoke, UK.
Hugh
H
Bethell
Warwick Medical School, University of Warwick, Coventry, UK.
Scott
S
Weich
Warwick Medical School, University of Warwick, Coventry, UK.
Margaret
M
Thorogood
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality* / Q000534:rehabilitation*; D010809:Physical Fitness; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D017741:Survivors / Q000706:statistics & numerical data*; D006113:United Kingdom