4 years ago

Impact of Cardiorespiratory Fitness on Frequency of Atrial Fibrillation, Stroke and All-Cause Mortality

Benefits of regular exercise on cardiovascular health are well recognized, but the impact of cardiorespiratory fitness on incidence of atrial fibrillation (AF) and stroke, and, particularly, risk of stroke and mortality in patients with AF is less clear. From 1993 through 2010, patients referred for a treadmill exercise test (TMET) at the Mayo Clinic Integrated Stress Center, Rochester, MN were retrospectively identified (N=76,857). From this, 14,094 residents of Olmsted and neighboring counties were selected. Exclusions: age<18 years; prior history of heart failure, structural/ valvular heart disease, AF/ flutter, or stroke; or non-standard TMET protocol. Functional Aerobic Capacity (FAC) was calculated from age and sex-specific TMET performances. Subjects were divided into 4 groups at baseline based on quartiles of FAC and followed through January 2016. Final study cohort included 12,043 patients. During median follow-up of 14 (9 to 17) years, 1,222 patients developed incident AF, 1,128 developed stroke, and 1,590 patients died. Each 10% increase in FAC was associated with a decrease in the risk of incident AF, stroke, and mortality by 7% [0.93(0.91-0.96, p<.001)], 8% [0.92(0.89-0.94, p<.001)], and 16% [0.84(0.82-0.86, p<.001)], respectively. In the subset of patients who developed incident AF with baseline FAC <75%, risks of both stroke [1.40(1.04-1.90, p=.01)] and mortality [3.20 (2.11-4.58, p<.001)] were significantly higher compared to AF patients with baseline FAC≥105%. In conclusion, better cardiorespiratory fitness is associated with lower risk of incident AF, stroke, and mortality. Similarly, risk of stroke and mortality in patients with AF is also inversely associated with cardiorespiratory fitness.

Publisher URL: www.sciencedirect.com/science

DOI: S000291491731593X

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