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Cardiorespiratory Fitness and the Risk of First Acute Myocardial Infarction: The HUNT Study.

ABSTRACT: Background The majority of studies evaluating cardiorespiratory fitness ( CRF ) as a cardiovascular risk factor use cardiovascular mortality and not cardiovascular disease events as the primary end point, and generally do not include women. The aim of this study was to investigate the association of estimated CRF ( eCRF ) with the risk of first acute myocardial infarction ( AMI ). Methods and Results We included 26 163 participants (51.5% women) from the HUNT study (Nord-Trøndelag Health Study), with a mean age of 55.7 years, without cardiovascular disease at baseline. Baseline eCRF was grouped into tertiles. AMI was derived from hospital records and deaths from the Norwegian Cause of Death Registry. We used Fine and Gray regression modeling to estimate subdistribution hazards ratio ( SHR ) of AMI , accounting for competing risk of death. During a mean (range) follow-up of 13 (0.02-15.40) years (347 462 person-years), 1566 AMI events were recorded. In fully adjusted models men in the 2 highest eCRF had 4% ( SHR : 0.96, 95% CI : 0.83-1.11) and 10% ( SHR : 0.90, 95% CI : 0.77-1.05) lower SHR of AMI , respectively, when compared with men in the lowest tertile. The corresponding numbers in women were 12% ( SHR : 0.88, 95% CI : 0.72-1.08) and 25% ( SHR : 0.75, 95% CI : 0.60-0.95). Conclusions eCRF was inversely associated with risk of AMI event among women but not in men. Our data suggest that high eCRF may have substantial benefit in reducing the risk of AMI . Therefore, our data suggest that an increased focus on eCRF as a cardiovascular disease risk marker in middle-aged and older adults is warranted.

SUBMITTER: Shigdel R

PROVIDER: S-EPMC6512140 | biostudies-literature | 2019 May

REPOSITORIES: biostudies-literature

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Cardiorespiratory Fitness and the Risk of First Acute Myocardial Infarction: The HUNT Study.

Shigdel Rajesh R Dalen Håvard H Sui Xuemei X Lavie Carl J CJ Wisløff Ulrik U Ernstsen Linda L

Journal of the American Heart Association 20190501 9

Background The majority of studies evaluating cardiorespiratory fitness ( CRF ) as a cardiovascular risk factor use cardiovascular mortality and not cardiovascular disease events as the primary end point, and generally do not include women. The aim of this study was to investigate the association of estimated CRF ( eCRF ) with the risk of first acute myocardial infarction ( AMI ). Methods and Results We included 26 163 participants (51.5% women) from the HUNT study (Nord-Trøndelag Health Study), ...[more]

PMID: 30991880

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Project description:Peripheral blood samples of patients with acute myocardial infarction were matched with those of control patients to identify possible differences in corresponding gene expression profiles. The controls were matched to cases based on gender, age, status of diabetes mellitus and smoking status. Six months cardiovascular survival status of the cases was used to identify two distinct subgroups among the cases. Linear models for microarray data (M-bM-^@M-^XlimmaM-bM-^@M-^Y) were employed to identify differential gene expression. Shrunken centroids technique helped in identifying the subsets of differentially expressed genes with predictive properties in independent samples. Predictive properties were evaluated using bootstrap sampling. Using the limma modeling with the log-fold change threshold of one (clinical significance) and StoreyM-bM-^@M-^Ys q-value approach (statistical significance), sixty transcripts were found to be both clinically and statistically differentially expressed among the cases not surviving the follow-up period relative to controls, while no such transcripts were observed among other surviving cases. The two subgroups of cases exhibited fourteen differentially expressed transcripts. Predictive modeling indicated sixteen out of sixty transcripts to best discriminate between the controls and cases who died during the follow-up period from cardiovascular causes, while for the surviving cases the already non-significant set of transcripts could not be further reduced. Eleven out of fourteen transcripts were found to best discriminate between the two groups of cases using shrunken centroids. The study identified genes, which were differentially expressed during the acute myocardial infarction, including those associated with short-term fatality of the cases. The genome-wide study used matched case-control design, with 97 samples of 90 patients in three disease groups. Matched control samples were used and several (7) technical replicates were performed.

Dataset Information

Cardiorespiratory Fitness and the Risk of First Acute Myocardial Infarction: The HUNT Study.

Publications

Cardiorespiratory Fitness and the Risk of First Acute Myocardial Infarction: The HUNT Study.

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