P980Physical activity and outcome in patients with atrial fibrillation

Abstract

Background: Increased physical activity (PA) is associated with an improved prognosis in healthy individuals and patients with cardiovascular diseases. However, the benefits of PA and the amount needed are much less clear among patients with atrial fibrillation (AF). Methods: The Basel Atrial Fibrillation Cohort study (BEAT-AF) is a prospective, multicenter cohort study that enrolled 1541 patients with documented AF. Patients reported whether they perform exercise on a regular basis. PA was quantified using the International Physical Activity Questionnaire (IPAQ). Three PA groups were defined: group 1: sedentary lifestyle; group 2: any moderate PA but no vigorous PA; group 3: any vigorous PA. The occurrence of all-cause death, cardiovascular death, major adverse cardiovascular events (MACE), major bleedings, heart failure hospitalization, stroke and myocardial infarction was assessed. To assess the relationships between PA and outcomes, Cox proportional hazards models were used to calculate hazard ratios (HR) and to adjust for clinically important confounders. Results: The mean follow-up duration was 3.8±1.4years. Mean age was 69±12years, mean CHA2DS2-VASc score was 2.9±1.8. Exercise on a regular Basis was associated with a lower risk of all-cause death (HR 0.51, 95% CI 0.35- 0.74), cardiovascular death (0.54, 0.33-0.90), MACE (0.66, 0.47-0.92), and major bleeding (0.45, 0.27-0.75). Vigorous PA conferred a lower risk of adverse events compared with moderate PA for most events, as shown in the table. Conclusions: Our study shows that regular PA is strongly associated with a reduced risk of death, cardiovascular death and major bleeding in patients with AF, and there was an inverse dose-response relationship for most outcomes. Regular PA may be beneficial in patients with AF.