title: Do heart failure status and psychosocial variables moderate the relationship between leisure time physical activity and mortality risk among patients with a history of myocardial infarction?
abstract: Leisure time physical activity (LTPA) is inversely related to mortality risk among patients with a history of myocardial infarction (MI). The aims were to explore if heart failure (HF) status and psychosocial variables moderate the association.
  
  
  
  Participants (n = 1169) were from a multi-center prospective cohort study. Information on LTPA (none, irregular,1-150, 151-300 and >300 weekly minutes), depression, social support and other prognostic indicators were collected 10-13 years after index MI. Cox regressions were conducted, adjusting for potential confounders. In case of significant moderation by HF-status or psychosocial variables, stratified analyses were performed.
  
  
  
  During follow-up (M = 8.4 years), 25.6 % of the sample had died. LTPA was inversely associated with mortality (p for trend < 0.01 in all models). HF did not, but psychosocial variables did, moderate the association. In the LTPA category 1-150 weekly minutes, patients with a high level of depression had a lower mortality risk in comparison to those with a low level (hazard ratios (95 % confidence intervals) were 0.43 (0.25, 0.75) versus 0.69 (0.36, 1.32)), and patients with a low level of social support had a lower mortality risk in comparison to those with a high level (0.40 (0.21, 0.77) versus 0.71 (0.39, 1.27)). In the category >300 min, patients with a high level of social support had a lower mortality risk than those with a low level (0.38 (0.19, 0.79) versus 0.51 (0.30, 0.87)).
  
  
  
  LTPA was inversely related to mortality risk of post-MI patients. HF did not moderate the relationship; depression and social support partially did.
authors.affiliation: Philips Research, Eindhoven, The Netherlands. rony.calo@philips.com.|EMGO Institute for Health and Care Research and the Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands. rony.calo@philips.com.
authors.forename: Rony
authors.identifier: 0000-0002-6097-091X
authors.initials: R
authors.lastname: Oosterom-Calo
authors.affiliation: EMGO Institute for Health and Care Research and the Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Saskia J
authors.initials: SJ
authors.lastname: Te Velde
authors.affiliation: Philips Research, Eindhoven, The Netherlands.
authors.forename: Wim
authors.initials: W
authors.lastname: Stut
authors.affiliation: Department of Rehabilitation, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Yaacov
authors.initials: Y
authors.lastname: Drory
authors.affiliation: Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty ofMedicine, Tel Aviv University, Tel Aviv, Israel.|AmsterdamSchool for Communication Research, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Johannes
authors.initials: J
authors.lastname: Brug
authors.affiliation: Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty ofMedicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Yariv
authors.initials: Y
authors.lastname: Gerber
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006333:Heart Failure / Q000209:etiology / Q000401:mortality / Q000534:rehabilitation*; D006801:Humans; D007557:Israel / Q000453:epidemiology; D007899:Leisure Activities; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D009203:Myocardial Infarction / Q000150:complications / Q000401:mortality* / Q000534:rehabilitation*; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D011795:Surveys and Questionnaires; D015996:Survival Rate / Q000639:trends
keywords: Depression; Exercise; Heart failure; Leisure time physical activity; Mortality; Post-MI; Psychosocial variables; Social support