High Fitness Level May Reduce Mortality After First Heart Attack

MedicalResearch.com Interview with:
Gabriel E. Shaya MS

University of Miami Miller School of Medicine
MD/MPH Candidate 2016

Medical Research: What is the background for this study?

Response: High exercise capacity has been established as an important protective factor against a wide array of poor health indicators and outcomes including cardiovascular morbidity and mortality. Most of the studies assessing the association of exercise capacity and cardiovascular outcomes have done so over an extended period of followup, however, whether high exercise capacity may influence the risk of early mortality following a first myocardial infarction has not been investigated. This is the question that we sought to answer in our study.

Medical Research: What are the main findings?

Response: Our study found that high exercise capacity was associated with statistically significant and clinically meaningful risk reductions in mortality in the short-term following a first myocardial infarction. Achieving the highest category of fitness in our cohort was associated with as much as a 60% mortality risk reduction relative to those in the least fit category, and similar magnitudes of benefit were observed to persist up to 1 year after a myocardial infarction. Importantly, the greatest risk reductions were observed when comparing the least fit patients to those with moderate fitness, suggesting that those with relatively low fitness may stand to benefit most from even just modest fitness improvements.

Medical Research: What should clinicians and patients take away from your report?

Response: Our novel results suggest that high fitness levels are associated with lower risk of death shortly following a first myocardial infarction. This information can be communicated in counseling discussions with patients to emphasize the powerful and multifaceted benefits to maintaining high fitness levels.

Medical Research: What recommendations do you have for future research as a result of this study?

Response: As our study only took one measure of fitness prior to incident myocardial infarction, future studies may investigate whether temporal changes in fitness can influence cardiovascular outcomes. Additionally, including measures of myocardial infarction severity, may address whether the results we observed were due to fitter people having less severe heart attacks, rather than being more robust to myocardial injury.

MedicalResearch: Is there anything else you would like to add?

Response: Lifestyle modification counseling should always be a point of attention in the high risk patient. We are pleased to present our findings that provide yet another reason for patients and clinicians to pay close attention to fitness as a powerful risk factor.


High Exercise Capacity Attenuates the Risk of Early Mortality After a First Myocardial Infarction

Shaya, Gabriel E. et al.

Mayo Clinic Proceedings , Volume 91 , Issue 2 , 129 – 139
DOI: http://dx.doi.org/10.1016/j.mayocp.2015.11.012

Gabriel E. Shaya (2016). High Fitness Level Reduces Mortality After First Heart Attack