Effects of Physical Activity and Exercise Training on Cardiovascular Risk in Coronary Artery Disease Patients With and Without Type 2 Diabetes

Karjalainen, Jaana; Kiviniemi, Antti M.; Hautala, Arto J.; Piira, Olli-Pekka; Lepojärvi, E. Samuli; Perkiömäki, Juha S.; Junttila, M. Juhani; Tulppo, Mikko P.

doi:10.2337/dc14-2216

Cited by 43 publications

(34 citation statements)

References 35 publications

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“…The Saltin-Grimby Physical Activity Level Scale has shown good validity 12 and has been shown to be related to both cardiovascular risk factors 12,13 and outcomes 5 . Longitudinal analysis of LTPA was based on our previous report 14 , where the optimal cutoff value for LTPA in prediction of total mortality by Youden's index was < irregular. Based on this cutoff value, the patients were categorized REACH risk score for cardiovascular death 15 were also calculated at the baseline and at 2 years.…”

Section: Methodsmentioning

confidence: 99%

Effect of Changes in Physical Activity on Risk for Cardiac Death in Patients With Coronary Artery Disease

Lahtinen

Toukola

Junttila

et al. 2018

The American Journal of Cardiology

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Leisure-time physical activity (LTPA) is associated with longevity in patients with coronary artery disease (CAD). However, less is known about prognostic significance of longitudinally assessed LTPA in patients with stable CAD. The present study assessed the relationship between changes in LTPA and cardiac mortality in patients with CAD. Patients with angiographically documented CAD (n = 1,746) underwent clinical examination and echocardiography at the baseline. Lifestyle factors, including LTPA (inactive, irregularly active, active, highly active), were surveyed at baseline and after 2 years' follow-up. Thereafter, the patients entered the follow-up (median: 4.5 years; first to third quartile: 3.4 to 5.8 years) during which cardiac deaths were registered (n = 68, 3.9%). The patients who remained inactive (n = 114, 18 events, 16%) and became inactive (n = 228, 18 events, 8%) had 7.6- (95% confidence interval [CI] 4.2 to 13.6) and 3.7-fold (95% CI 2.1 to 6.7) univariate risk for cardiac death compared with those who remained at least irregularly active (n = 1,351, 30 events, 2%), respectively. After adjustment for age, gender, body mass index, diabetes, previous myocardial infarction, left ventricular ejection fraction, angina pectoris grading, cardiovascular event during initial 2-year follow-up, smoking and alcohol consumption, the patients who remained inactive and became inactive still had 4.9- (95% CI 2.4 to 9.8, p <0.001) and 2.4-fold (95% CI 1.3 to 4.5, p <0.01) risk for cardiac death, respectively, compared with patients remaining at least irregularly active. In conclusion, LTPA has important prognostic value for cardiac death in patients with stable CAD. Even minor changes in LTPA over 2 years were related to the subsequent risk for cardiac death.

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Section: Methodsmentioning

confidence: 99%

Effect of Changes in Physical Activity on Risk for Cardiac Death in Patients With Coronary Artery Disease

Lahtinen

Toukola

Junttila

et al. 2018

The American Journal of Cardiology

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“…The benefits of extensive exercise have exceeded previous expectations, including primary prevention, active part of the treatment, improvement of life quality, and prognosis under chronic or incurable diseases, and prevention of complications and recurrence, of a wide range of diseases, including cardiovascular (1,2), hypertension, type 2 diabetes mellitus (T2DM) (1), dyslipidemia, cancers (3)(4)(5)(6), cognitive function (7), and all quality of life domains (8)(9)(10).…”

Section: Introductionmentioning

confidence: 98%

Inter-correlations Among Clinical, Metabolic, and Biochemical Parameters and Their Predictive Value in Healthy and Overtrained Male Athletes: The EROS-CORRELATIONS Study

Cadegiani

Kater

2019

Front. Endocrinol.

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Objectives: The Endocrine and Metabolic Responses on Overtraining Syndrome (EROS) study identified multiple hormonal and metabolic conditioning processes in athletes, and underlying mechanisms and biomarkers of overtraining syndrome (OTS). The present study's objective was to reveal independent predictors and linear correlations among the parameters evaluated in the EROS study to predict clinical, metabolic, and biochemical behaviors in healthy and OTS-affected male athletes. Methods: We used multivariate linear regression and linear correlation to analyze possible combinations of the 38 parameters evaluated in the EROS study that revealed significant differences between healthy and OTS-affected athletes. Results: The testosterone-to-estradiol (T:E) ratio predicted the measured-to-predicted basal metabolic rate (BMR) ratio; the T:E ratio and total testosterone level were inversely predicted by fat mass and estradiol was not predicted by any of the non-modifiable parameters. Early and late growth hormone, cortisol, and prolactin responses to an insulin tolerance test (ITT) were strongly correlated. Hormonal responses to the ITT were positively correlated with fat oxidation, predicted-to-measured BMR ratio, muscle mass, and vigor, and inversely correlated with fat mass and fatigue. Salivary cortisol 30 min after awakening and the T:E ratio were inversely correlated with fatigue. Tension was inversely correlated with libido and directly correlated with body fat. The predicted-to-measured BMR ratio was correlated with muscle mass and body water, while fat oxidation was directly correlated with muscle mass and inversely correlated with fat mass. Muscle mass was directly correlated with body water, and extracellular water was directly correlated with body fat and inversely correlated with body water and muscle mass. Conclusions: Hypothalamic-pituitary responses to stimulation were diffuse and indistinguishable between the different axes. A late hormonal response to stimulation, increased cortisol after awakening, and the T:E ratio were correlated with vigor and Cadegiani and Kater The EROS-CORRELATIONS Study fatigue. The T:E ratio was also correlated with body metabolism and composition, testosterone was predicted by fat mass, and estradiol predicted anger. Hydration status was inversely correlated with edema, and inter-correlations were found among fat oxidation, hydration, and body fat.

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“…Similarly, good aerobic fitness is associated with a low concentration of ox-LDL lipids [ 21 ]. However, this two-year home-based exercise training was not intensive enough to induce changes in serum lipids [ 25 ], and ox-LDL and ox-HDL lipids.…”

Section: Discussionmentioning

confidence: 99%

“…The ARTEMIS (innovation to reduce cardiovascular complications of diabetes at the intersection) study was initiated to assess the significance of autonomic, electrical, coronary angiographic, and metabolic markers in predicting cardiovascular events among CAD patients with (CAD + T2D patients) and without T2D (CAD patients) [ 25 ]. In addition to this, the study aimed to assess the prognostic significance of these markers in predicting CV events among CAD patients with and without T2D.…”

Section: Methodsmentioning

confidence: 99%

Effects of a Two-Year Home-Based Exercise Training Program on Oxidized LDL and HDL Lipids in Coronary Artery Disease Patients with and without Type-2 Diabetes

et al. 2018

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We investigated the effect of two-year home-based exercise training program on oxidized low-density lipoprotein LDL (ox-LDL) and high-density lipoprotein HDL (ox-HDL) lipids in patients with coronary artery disease (CAD), both with and without type-2 diabetes (T2D). Analysis of lipoprotein-oxidized lipids was based on the determination of baseline conjugated dienes in lipoprotein lipids. In order to study the effect of an exercise load on ox-LDL and ox-HDL lipids patients in both CAD and CAD + T2D intervention, groups were divided in three based on exercise load (high, medium, and low). During the two-year home-based exercise training program, the study showed that only higher training volume resulted in a decreased concentration of ox-LDL, while the two groups with lower training volumes showed no change. This result indicates that the training load needs to be sufficiently high in order to decrease the concentration of atherogenic ox-LDL lipids in patients with CAD and CAD + T2D. Interestingly, the concentration of ox-HDL did not change in any of the subgroups. This could indicate that the lipid peroxide-transporting capacity of HDL, suggested by results from exercise training studies in healthy adults, may not function similarly in CAD patients with or without T2D. Moreover, the lipid-lowering medication used may have had an influence on these results.

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Effects of Physical Activity and Exercise Training on Cardiovascular Risk in Coronary Artery Disease Patients With and Without Type 2 Diabetes

Cited by 43 publications

References 35 publications

Effect of Changes in Physical Activity on Risk for Cardiac Death in Patients With Coronary Artery Disease

Effect of Changes in Physical Activity on Risk for Cardiac Death in Patients With Coronary Artery Disease

Inter-correlations Among Clinical, Metabolic, and Biochemical Parameters and Their Predictive Value in Healthy and Overtrained Male Athletes: The EROS-CORRELATIONS Study

Effects of a Two-Year Home-Based Exercise Training Program on Oxidized LDL and HDL Lipids in Coronary Artery Disease Patients with and without Type-2 Diabetes

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