Modelling coronary heart disease mortality in Northern Ireland between 1987 and 2007

Hughes, J; Kee, Frank; Bennett, Kathleen; O’Flaherty, Martı́n; Critchley, Julia; Cupples, Margaret; Capewell, Simon

doi:10.1136/jech.2011.143586.21

Cited by 1 publication

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“…The majority of trials of cardiac rehabilitation have followed participants for 2 years or less, 17 and of the studies that have reported on long-term survival, very few consider fitness as a possible explanatory variable. 13 14 35 However, a recent Canadian study of a similar duration to ours, but which followed a selected cohort of patients, 30 also found that baseline fitness and fitness improvement were associated with reduced all-cause mortality. The authors selected a group of patients who had undergone cardiac catherisation procedures, had completed a 12-week exercise-based cardiac rehabilitation course, had returned 12 weeks later for a repeated assessment, and had survived for at least 6 months from the date of catherisation.…”

Section: Discussionsupporting

confidence: 49%

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

et al. 2015

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ObjectivesTo 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.DesignCohort 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).SettingA community-based National Health Service (NHS) cardiac rehabilitation programme serving the Basingstoke and Alton area in Hampshire, UK.ParticipantsAn 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.Main outcome measuresCardiovascular mortality and all-cause mortality.ResultsA 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.ConclusionsPrior 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.

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