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Abstract：
UNASSIGNED: Physical activity (PA) is an important component of secondary prevention after myocardial infarction (MI). The mortality risk of MI survivors varies at different post-MI periods, yet the time-varying effect of total PA is unclear. We aimed to investigate the association between different volumes and patterns of total PA and mortality at different post-MI periods.
UNASSIGNED: Using data from the China Patient-centered Evaluative Assessment of Cardiac Events Million Persons Project, we divided the screened MI survivors into within-1-year and beyond-1-year groups based on the duration between their baseline interview and MI onset. Total PA was divided into insufficient ( < 3000 metabolic equivalent of task [MET] minutes/week) and sufficient PA. Sufficient PA was further categorized as moderate and high (3000-4500 and > 4500 MET minutes/week) volumes; leisure ( ≥ 50%) and non-leisure ( > 50%) patterns. Data on mortality were derived from the National Mortality Surveillance System and Vital Registration of the Chinese Center for Disease Control and Prevention. Cox proportional hazard models were fitted to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Restricted cubic spline regression analyses were performed to examine the dose-response association between PA and mortality.
UNASSIGNED: During the follow-up (median 3.7 years) of the 20,653 post-MI patients, 751 patients died. In the within-1-year group, moderate (HR: 0.59, 95% CI: 0.40 to 0.88) and high (0.63, 0.45 to 0.88) volumes and both patterns (leisure: 0.52, 0.29 to 0.94; non-leisure: 0.64, 0.46 to 0.88) of PA were all associated with significantly lower risk of mortality, compared with insufficient PA. In the beyond-1-year group, the association was observed in high volume (0.69, 0.56 to 0.86) and both patterns (leisure: 0.64, 0.48 to 0.87; non-leisure: 0.79, 0.65 to 0.97). A non-linear relationship between PA and mortality was found in the within-1-year group (p for non-linearity < 0.001), while a linear relationship was demonstrated in the beyond-1-year group (p for non-linearity = 0.107).
UNASSIGNED: Sufficient total PA was associated with mortality risk reduction after MI, either leisure or non-leisure pattern. Different dose-response associations between PA and mortality were found at different post-MI periods. These results could promote individualized and scientifically derived secondary prevention strategies for MI.
UNASSIGNED: Using data from the China Patient-centered Evaluative Assessment of Cardiac Events Million Persons Project, we divided the screened MI survivors into within-1-year and beyond-1-year groups based on the duration between their baseline interview and MI onset. Total PA was divided into insufficient ( < 3000 metabolic equivalent of task [MET] minutes/week) and sufficient PA. Sufficient PA was further categorized as moderate and high (3000-4500 and > 4500 MET minutes/week) volumes; leisure ( ≥ 50%) and non-leisure ( > 50%) patterns. Data on mortality were derived from the National Mortality Surveillance System and Vital Registration of the Chinese Center for Disease Control and Prevention. Cox proportional hazard models were fitted to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Restricted cubic spline regression analyses were performed to examine the dose-response association between PA and mortality.
UNASSIGNED: During the follow-up (median 3.7 years) of the 20,653 post-MI patients, 751 patients died. In the within-1-year group, moderate (HR: 0.59, 95% CI: 0.40 to 0.88) and high (0.63, 0.45 to 0.88) volumes and both patterns (leisure: 0.52, 0.29 to 0.94; non-leisure: 0.64, 0.46 to 0.88) of PA were all associated with significantly lower risk of mortality, compared with insufficient PA. In the beyond-1-year group, the association was observed in high volume (0.69, 0.56 to 0.86) and both patterns (leisure: 0.64, 0.48 to 0.87; non-leisure: 0.79, 0.65 to 0.97). A non-linear relationship between PA and mortality was found in the within-1-year group (p for non-linearity < 0.001), while a linear relationship was demonstrated in the beyond-1-year group (p for non-linearity = 0.107).
UNASSIGNED: Sufficient total PA was associated with mortality risk reduction after MI, either leisure or non-leisure pattern. Different dose-response associations between PA and mortality were found at different post-MI periods. These results could promote individualized and scientifically derived secondary prevention strategies for MI.
摘要：
■身体活动（PA）是心肌梗死（MI）后二级预防的重要组成部分。MI幸存者的死亡风险在不同的MI后时期有所不同，然而总PA的时变效应尚不清楚.我们旨在调查不同数量和模式的总PA与不同MI后时期死亡率之间的关系。
■使用中国以患者为中心的百万人心脏事件评估项目的数据，我们根据基线访谈和MI发病之间的持续时间,将接受筛查的MI幸存者分为1年以内和1年以上组.总PA分为不足(<3000代谢当量的任务[MET]分钟/周)和充足的PA。足够的PA被进一步分类为中等和高（3000-4500和>4500MET分钟/周）体积；休闲（≥50％）和非休闲（>50％）模式。死亡率数据来自国家死亡率监测系统和中国疾病预防控制中心的生命登记。拟合Cox比例风险模型以估计风险比(HR)和95%置信区间(CI)。进行限制性三次样条回归分析以检查PA和死亡率之间的剂量反应相关性。
■在20,653名MI后患者的随访（中位数为3.7年）中，751名患者死亡。在一年内的组中，中度（HR：0.59，95％CI：0.40至0.88）和高（0.63，0.45至0.88）量和两种模式（休闲：0.52，0.29至0.94；非休闲：0.64，0.46至0.88）的PA都与显着较低的死亡风险相关，与PA不足相比。在一年以上的组中，在大量(0.69,0.56~0.86)和两种模式(休闲:0.64,0.48~0.87;非休闲:0.79,0.65~0.97)中观察到了这种关联.在1年内发现PA和死亡率之间的非线性关系（p表示非线性<0.001），而在超过1年的组中证明了线性关系（非线性p=0.107）。
■足够的总PA与MI后死亡风险降低相关，休闲或非休闲模式。在MI后的不同时期发现PA和死亡率之间的不同剂量反应关联。这些结果可以促进个性化和科学衍生的MI二级预防策略。
■使用中国以患者为中心的百万人心脏事件评估项目的数据，我们根据基线访谈和MI发病之间的持续时间,将接受筛查的MI幸存者分为1年以内和1年以上组.总PA分为不足(<3000代谢当量的任务[MET]分钟/周)和充足的PA。足够的PA被进一步分类为中等和高（3000-4500和>4500MET分钟/周）体积；休闲（≥50％）和非休闲（>50％）模式。死亡率数据来自国家死亡率监测系统和中国疾病预防控制中心的生命登记。拟合Cox比例风险模型以估计风险比(HR)和95%置信区间(CI)。进行限制性三次样条回归分析以检查PA和死亡率之间的剂量反应相关性。
■在20,653名MI后患者的随访（中位数为3.7年）中，751名患者死亡。在一年内的组中，中度（HR：0.59，95％CI：0.40至0.88）和高（0.63，0.45至0.88）量和两种模式（休闲：0.52，0.29至0.94；非休闲：0.64，0.46至0.88）的PA都与显着较低的死亡风险相关，与PA不足相比。在一年以上的组中，在大量(0.69,0.56~0.86)和两种模式(休闲:0.64,0.48~0.87;非休闲:0.79,0.65~0.97)中观察到了这种关联.在1年内发现PA和死亡率之间的非线性关系（p表示非线性<0.001），而在超过1年的组中证明了线性关系（非线性p=0.107）。
■足够的总PA与MI后死亡风险降低相关，休闲或非休闲模式。在MI后的不同时期发现PA和死亡率之间的不同剂量反应关联。这些结果可以促进个性化和科学衍生的MI二级预防策略。
