Accelerometer-derived physical activity and risk of atrial fibrillation
Accelerometer-derived physical activity and risk of atrial fibrillation
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DOI：
10.1093/eurheartj/ehab250
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发表时间：
2021-05-25
影响因子：
39.3
通讯作者：
Lubitz, Steven A.
中科院分区：
文献类型：
--
作者：
Khurshid, Shaan;Weng, Lu-Chen;Lubitz, Steven A.
目的身体活动可能是一个重要的可修改的风险因素心房颤动（AF），但协会一直是可变的，一般基于自我报告activity.Methods和结果我们分析了93 669名参与者的英国生物银行前瞻性队列研究没有流行的AF谁戴了一个手腕为基础的加速度计1周。我们对测量的活动是否符合欧洲心脏病学会、美国心脏协会和世界卫生组织的标准建议[中度至剧烈体力活动（MVPA）>= 150分钟/周]进行了分类。我们使用考克斯比例风险模型检验了遵循指南的活动与房颤（原发性）和卒中（继发性）事件之间的相关性，该模型根据年龄、性别和基因组流行病学心脏和衰老研究房颤（CHARGE-AF）风险评分队列的每个组成部分进行了调整。我们还评估了加速度计衍生和自我报告的活动之间的相关性。平均年龄为628岁，57%为女性。在中位数为5.2年的时间内，发生了2338起AF事件。在多变量校正模型中，遵循指南的活动与较低的房颤风险相关[风险比（HR）0.82，95%置信区间（CI）0.75-0.89;发生率3.5/1000人-年，95% CI 3.3-3.8 vs. 6.5/1000人-年，95% CI 6.1-6.8]和卒中（HR 0.76，95% CI 0.64-0.90;发生率1.0/1000人年，95% CI 0.9-1.1 vs. 1.8/1000人年，95% CI 1.6-2.0）。加速度计得出的MVPA与自我报告的MVPA之间的相关性较弱（斯皮尔曼r=0.16，95% CI 0.16-0.17）。自我报告的活动与事件AF或stroke.Conclusions更大的加速度计衍生的体力活动与AF和中风的风险较低。未来降低房颤风险的预防措施在目标是遵守客观活动阈值时可能最有效。[图形]。
Aims Physical activity may be an important modifiable risk factor for atrial fibrillation (AF), but associations have been variable and generally based on self-reported activity.Methods and results We analysed 93 669 participants of the UK Biobank prospective cohort study without prevalent AF who wore a wrist-based accelerometer for 1 week. We categorized whether measured activity met the standard recommendations of the European Society of Cardiology, American Heart Association, and World Health Organization [moderate-to-vigorous physical activity (MVPA) >= 150min/week]. We tested associations between guideline-adherent activity and incident AF (primary) and stroke (secondary) using Cox proportional hazards models adjusted for age, sex, and each component of the Cohorts for Heart and Aging Research in Genomic Epidemiology AF (CHARGE-AF) risk score. We also assessed correlation between accelerometer-derived and self-reported activity. The mean age was 628 years and 57% were women. Over a median of 5.2 years, 2338 incident AF events occurred. In multivariable adjusted models, guideline-adherent activity was associated with lower risks of AF [hazard ratio (HR) 0.82, 95% confidence interval (CI) 0.75-0.89; incidence 3.5/1000 person-years, 95% CI 3.3-3.8 vs. 6.5/1000 person-years, 95% CI 6.1-6.8] and stroke (HR 0.76, 95% CI 0.64-0.90; incidence 1.0/1000 person-years, 95% CI 0.9-1.1 vs. 1.8/1000 person-years, 95% CI 1.6-2.0). Correlation between accelerometer-derived and self-reported MVPA was weak (Spearman r=0.16, 95% CI 0.16-0.17). Self-reported activity was not associated with incident AF or stroke.Conclusions Greater accelerometer-derived physical activity is associated with lower risks of AF and stroke. Future preventive efforts to reduce AF risk may be most effective when targeting adherence to objective activity thresholds.[GRAPHICS].