Physical activity status and acute coronary syndromes survival The GREECS (Greek Study of Acute Coronary Syndromes) study

J Am Coll Cardiol. 2008 May 27;51(21):2034-9. doi: 10.1016/j.jacc.2008.01.053.


Objectives: We sought to evaluate the association between physical activity levels and the clinical outcome at presentation, as well as the 30-day prognosis of hospitalized patients with acute coronary syndromes (ACS).

Background: Regular physical activity has been associated with decreased risk of coronary heart disease. However, less is known about the effects of life-long physical activity on ACS prognosis.

Methods: From October 2003 to September 2004, a sample of 6 hospitals located in urban and rural Greek regions were selected, and almost all of their ACS patients were enrolled into the study (2,172 patients were included in the study; 76% men and 24% women). Logistic regression models were applied to evaluate the effect of physical activity status (as assessed using the International Physical Activity Questionnaire) on in-hospital mortality and the 30-day outcome of cardiovascular events (death or rehospitalization due to cardiovascular disease).

Results: An inverse association was observed between the level of physical activity and troponin I levels at presentation (p = 0.01). Moreover, after taking into account various potential confounders, physical activity was associated with a 0.56-fold (95% confidence interval [CI] 0.32 to 0.90) lower odds of in-hospital mortality and a 0.80-fold (95% CI 0.50 to 0.99) lower odds of cardiovascular events within the first month after discharge.

Conclusion: In conclusion, physical activity is associated with a reduced severity of ACS, reduced in-hospital mortality rates, and improved short-term prognosis.

MeSH terms

  • Acute Coronary Syndrome / mortality
  • Acute Coronary Syndrome / physiopathology*
  • Aged
  • Angina, Unstable / mortality
  • Angina, Unstable / physiopathology
  • Diet
  • Exercise
  • Female
  • Hospital Mortality*
  • Humans
  • Male
  • Middle Aged
  • Motor Activity*
  • Myocardial Infarction / mortality
  • Myocardial Infarction / physiopathology
  • Prognosis
  • Smoking / epidemiology
  • Socioeconomic Factors