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. 2022 Aug 3;62(3):ezac126.
doi: 10.1093/ejcts/ezac126.

Cardiorespiratory fitness and the incidence of coronary surgery and postoperative mortality: the HUNT study

Benedikte Therese Smenes  1 , Bjarne Martens Nes  1 , Jon Magne Letnes  1   2   3 , Katrine Hordnes Slagsvold  1   4 , Ulrik Wisløff  1   5 , Alexander Wahba  1   4
Affiliations

Cardiorespiratory fitness and the incidence of coronary surgery and postoperative mortality: the HUNT study

Benedikte Therese Smenes et al. Eur J Cardiothorac Surg. .

Abstract

Objectives: Low physical activity and cardiorespiratory fitness are known risk factors for coronary artery disease, but how they affect the risk of undergoing coronary artery bypass graft surgery is not established. We explored how physical activity and estimated cardiorespiratory fitness affect the risk of coronary surgery and postoperative outcome.

Methods: Participants with no history of coronary disease from the second wave of the Trøndelag Health Study (HUNT2) were cross-linked with the local heart surgery register and the Norwegian Cause of Death Registry. Cardiorespiratory fitness was estimated by a previously developed algorithm using clinical and self-reported information. Fine-Gray competing risk analyses were used to calculate the risk of undergoing isolated coronary surgery across physical activity groups and estimated cardiorespiratory fitness (mL/kg/min) as quintiles and per 1 metabolic equivalent of task (MET) (3.5 mL/kg/min).

Results: We included 45,491 participants. The mean population age was 46.0 [standard deviation (SD) 15.8] years, and the mean estimated fitness was 41.3 (SD 8.9) mL/kg/min. A total of 672 (1.5%) participants underwent coronary surgery during the follow-up period. The risk of undergoing isolated coronary surgery was 26% [95% confidence interval (CI) 3-44] lower for those classified as highly active compared to those classified as least active. Further, an 11% (95% CI 6-15) lower risk per 1-MET (3.5 mL/kg/min) of higher fitness. Finally, we observed a 15% (95% CI 5-23) lower mortality risk after surgery per 1-MET of higher fitness among those undergoing surgery.

Conclusions: High levels of physical activity and high estimated fitness levels were inversely associated with the risk of developing coronary disease requiring surgery and overall mortality after surgery.

Keywords: Cardiorespiratory fitness; Coronary heart disease; Coronary heart surgery; Primary prevention.

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Figures

Figure 1:
Figure 1:
Cumulative incidence of events by physical activity group. Other: Other cardiac surgical procedures. CABG: coronary artery bypass graft surgery.
Figure 2:
Figure 2:
Cumulative incidence of events by quintiles of estimated cardiorespiratory fitness. CABG: coronary artery bypass graft surgery.
Figure 3:
Figure 3:
Adjusted survival curves for overall mortality after coronary artery bypass graft surgery by quintiles of cardiorespiratory fitness. Other: Other cardiac surgical procedures.
None
See this image and copyright information in PMC

Comment in

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