Exercise improves survival after heart procedure

By Joene Hendry

NEW YORK (Reuters Health) - Elderly individuals who maintain higher levels of physical activity have better survival rates after a heart attack and subsequent angiography to clear the coronary arteries, researchers in Italy and the U.S. suggest.

Dr. Dario Leosco, Federico II University, Naples, and colleagues assessed the daily physical activity levels maintained by 168 men and women, aged 70 years and older, after 30 days and 1 year, researchers report in the American Heart Journal.

Exercise questionnaires obtained at the time of angioplasty identified 52 patients who participated in less than 15 minutes of daily activity (low) and 66 who reported 15 to 30 minutes of daily activity (medium). The remaining 50 patients participated in more than 30 minutes of moderate physical activity (high), such as walking, gardening, or cycling, each day, Leosco said.

During the 30-day period following angioplasty cardiac deaths occurred in about 23 percent of the low activity group and in just over 18 percent of the medium activity group. By contrast, cardiac deaths occurred in just 4 percent of those in the high activity group.

"An active lifestyle is an independent predictor of survival in elderly patients who have undergone primary angioplasty for the treatment of acute myocardial infarction," Leosco told Reuters Health.

One-year outcomes showed cardiac deaths in nearly 29 and 23 percent of the low and medium activity groups, respectively, but in just 8 percent of the high activity group.

Those in the high activity group also had lower overall 30-day and 1-year rates of non-fatal events, including another heart attack, repeat angioplasty, congestive heart failure, and stroke, compared with those in the low and medium activity groups.

Furthermore, Leosco and colleagues note, taking up an active lifestyle after experiencing a sudden heart attack was associated with improved survival 1 year later.

"To this end," Leosco said, "we have to stimulate older subjects with cardiovascular disease to maintain a light to moderate amount of exercise involvement after an acute cardiac event."

SOURCE: American Heart Journal, August 2007.