Association between Time of Day of Sports-Related Physical Activity and the Onset of Acute Myocardial Infarction in a Chinese Population

PLOS ONE, Dec 2019

Objective To investigate the association between the time of day of sports-related physical activity and the onset of acute myocardial infarction (AMI) in a coronary artery disease (CAD) population in China. Methods Between February 2014 and March 2015, a total of 696 patients from Nanjing, China, who had CAD were studied and divided into two groups (Non-AMI and AMI groups). The work-related activity and sports-related physical activity information were obtained from a self-reporting predesigned patient questionnaire. Results Sports-related physical activity was associated with a lower risk of the onset of AMI, after adjusting the established and potential confounders, with an adjusted odds ratio (OR) of 0.67 (95% CI, 0.47–0.94) compared with those who did not have any sports-related physical activity. A dose–response relationship was observed for intensity, duration, and frequency of sports-related physical activity. Further stratification analysis revealed that the protective effects of sports-related physical activity were significant in the morning and evening groups, and patients who exercised in the evening were at a lower risk of AMI than those doing sports-related physical activity in the morning. The adjusted ORs for doing sports-related physical activity in the morning and evening groups were 0.60(0.36–0.98) and 0.56(0.37–0.87), respectively, compared with inactivity (all P<0.05). On the occurrence of AMI, doing sports-related physical activity in the evening had an adjusted OR of 0.93 (95% CI, 0.54–1.64, P = 0.824) compared with in the morning group. Conclusions Sports-related physical activity is associated with a lower risk of onset of AMI than inactivity in Chinese people. For CAD patients, we suggest they participate in sports-related physical activity of high intensity, long duration, and high frequency. Doing sports-related physical activity in the evening and in the morning have similar benefits on the prevention of the onset of AMI.

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Association between Time of Day of Sports-Related Physical Activity and the Onset of Acute Myocardial Infarction in a Chinese Population

January Association between Time of Day of Sports- Related Physical Activity and the Onset of Acute Myocardial Infarction in a Chinese Population Shan Zhao 0 1 2 Zhen Zhang 0 1 2 Qingqing Long 0 1 2 Yao Ma 0 1 2 Xiaoqing Lian 0 1 2 Yang Yang 0 1 2 Wei Gao 0 1 2 Zhong Chen 0 1 2 Liansheng Wang 0 1 2 0 Funding: The study was funded by grants from the National Natural Science Foundation of China (No 81270255), the Science and Technological Innovation Group of Jiangsu Higher Education Institution “Qing- Lan Project”(JX2161015030), the Priority Academic Program Development of Jiangsu Higher Education Institutions (PAPD), Pudong New Area Science and Technology Development Fund (PKJ2014-Y09 to Dr. Zhong Chen), and Shanghai Municipal Commission 1 Editor: Stephane Germain, Center for Interdisciplinary Research in Biology (CIRB) , FRANCE 2 1 Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University , Nanjing, 210029, China , 2 Department of Cardiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital , No. 600 Yishan Road, Shanghai, 200233 , China - Sports-related physical activity was associated with a lower risk of the onset of AMI, after adjusting the established and potential confounders, with an adjusted odds ratio (OR) of 0.67 (95% CI, 0.47–0.94) compared with those who did not have any sports-related physical activity. A dose–response relationship was observed for intensity, duration, and frequency of sports-related physical activity. Further stratification analysis revealed that the protective effects of sports-related physical activity were significant in the morning and evening groups, and patients who exercised in the evening were at a lower risk of AMI than those doing sports-related physical activity in the morning. The adjusted ORs for doing sportsrelated physical activity in the morning and evening groups were 0.60(0.36–0.98) and 0.56 (0.37–0.87), respectively, compared with inactivity (all P<0.05). On the occurrence of AMI, doing sports-related physical activity in the evening had an adjusted OR of 0.93 (95% CI, 0.54–1.64, P = 0.824) compared with in the morning group. To investigate the association between the time of day of sports-related physical activity and the onset of acute myocardial infarction (AMI) in a coronary artery disease (CAD) population in China. Between February 2014 and March 2015, a total of 696 patients from Nanjing, China, who had CAD were studied and divided into two groups (Non-AMI and AMI groups). The workrelated activity and sports-related physical activity information were obtained from a selfreporting predesigned patient questionnaire. OPEN ACCESS Data Availability Statement: All relevant data are within the paper. Objective Methods Results of Health and Family Planning Research Project (201440309 to Dr. Zhong Chen). Competing Interests: The authors have declared that no competing interests exist. Abbreviations: AMI, acute myocardial infarction; BMI, body mass index; BPAQ, Baecke physical activity questionnaire; CAD, coronary artery disease; CVD, cardiovascular disease; ECG, electrocardiograph; EEPA, energy expenditure in physical activity; HDL-C, high-density lipoprotein cholesterol; hsCRP, high sensitivity C-reactive protein; LBBB, left bundle branch block; LDL-C, lowdensity lipoprotein cholesterol; LVEF, left ventricular ejection fraction; MBPS, morning blood pressure surge; METs, metabolic equivalent; OR, odds ratio; SCD, sudden cardiac death; TC, total cholesterol; TG, triglyceride; WBC, white blood cell. Conclusions Sports-related physical activity is associated with a lower risk of onset of AMI than inactivity in Chinese people. For CAD patients, we suggest they participate in sports-related physical activity of high intensity, long duration, and high frequency. Doing sports-related physical activity in the evening and in the morning have similar benefits on the prevention of the onset of AMI. Introduction Worldwide, coronary artery disease (CAD) is the single most frequent cause of death. Nearly 7.4 million people die from CAD every year, accounting for 13.1% of all deaths [ 1 ]. Furthermore, in patients with CAD, acute myocardial infarction (AMI) is the leading cause of cardiac death. Substantial amounts of research indicate that physical activity has been associated with a reduced risk of CAD [ 2–5 ]. Physical activity not only decreased mortality in patients with established CAD, but also increased survival of CAD patients who participated in rehabilitation programs [ 6,7 ]. Although the benefit of physical activity is recognized, studies still have shown that physical activity is related to sudden cardiac death (SCD), even in a healthy population [ 8 ], and this problem worries people, especially patients with CAD. In the past few decades, evidence has been found to support the clinical significance of circadian variation with the onset of MI and SCD [ 9–12 ]. The study by Kanaley et a (...truncated)


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Shan Zhao, Zhen Zhang, Qingqing Long, Yao Ma, Xiaoqing Lian, Yang Yang, Wei Gao, Zhong Chen, Liansheng Wang. Association between Time of Day of Sports-Related Physical Activity and the Onset of Acute Myocardial Infarction in a Chinese Population, PLOS ONE, 2016, Volume 11, Issue 1, DOI: 10.1371/journal.pone.0146472