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ST段抬高型心肌梗死后运动训练参与度与心脏生物标志物峰值浓度之间的关联。

Association between engagement in exercise training and peak cardiac biomarker concentrations following ST-elevation myocardial infarction.

作者信息

de Koning Iris Apolonia, van Bakel B M A, Rotbi Hajar, Van Geuns Robert-Jan M, Cramer G Etienne, Pop Gheorghe A M, Eijsvogels Thijs, Thijssen Dick H J

机构信息

Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, the Netherlands.

Department of Cardiology, Radboudumc, Nijmegen, the Netherlands.

出版信息

BMJ Open Sport Exerc Med. 2023 Apr 11;9(2):e001488. doi: 10.1136/bmjsem-2022-001488. eCollection 2023.

Abstract

BACKGROUND

Regular exercise training is an important factor in prevention of myocardial infarction (MI). However, little is known whether exercise engagement prior to MI is related to the magnitude of post-MI cardiac biomarker concentrations and clinical outcomes.

OBJECTIVES

We tested the hypothesis that exercise engagement in the week prior MI is related to lower cardiac biomarker concentrations following ST-elevated MI (STEMI).

METHODS

We recruited hospitalised STEMI patients and assessed the amount of exercise engagement in the 7 days preceding MI onset using a validated questionnaire. Patients were classified as 'exercise' if they performed any vigorous exercise in the week prior MI, or as 'control' if they did not. Post-MI peak concentrations of high-sensitive cardiac troponin T (peak-hs-cTnT) and creatine kinase (peak-CK) were examined. We also explored whether exercise engagement prior MI is related to the clinical course (duration of hospitalisation and incidence of in-hospital, 30-day and 6-month major adverse cardiac events (reinfarction, target vessel revascularisation, cardiogenic shock or death)).

RESULTS

In total, 98 STEMI patients were included, of which 16% (n=16) was classified as 'exercise', and 84% (n=82) as 'control'. Post-MI peak-hs-cTnT and peak-CK concentrations were lower in the exercise group (941 (645-2925) ng/mL; 477 (346-1402) U/L, respectively) compared with controls (3136 (1553-4969) ng/mL, p=0.010; 1055 (596-2019) U/L, p=0.016, respectively). During follow-up, no significant differences were found between both groups.

CONCLUSION

Engagement in exercise is associated with lower cardiac biomarker peak concentrations following STEMI. These data could provide further support for the cardiovascular health benefits of exercise training.

摘要

背景

规律的运动训练是预防心肌梗死(MI)的重要因素。然而,对于心肌梗死发生前的运动参与是否与心肌梗死后心脏生物标志物浓度的变化幅度及临床结局相关,我们知之甚少。

目的

我们检验了这样一个假设,即心肌梗死前一周的运动参与与ST段抬高型心肌梗死(STEMI)后较低的心脏生物标志物浓度有关。

方法

我们招募了住院的STEMI患者,并使用一份经过验证的问卷评估心肌梗死发作前7天的运动参与量。如果患者在心肌梗死前一周进行了任何剧烈运动,则被归类为“运动组”;如果没有,则被归类为“对照组”。我们检测了心肌梗死后高敏心肌肌钙蛋白T的峰值浓度(峰值-hs-cTnT)和肌酸激酶的峰值浓度(峰值-CK)。我们还探讨了心肌梗死前的运动参与是否与临床病程(住院时间以及住院期间、30天和6个月时主要不良心脏事件(再梗死、靶血管血运重建、心源性休克或死亡)的发生率)有关。

结果

总共纳入了98例STEMI患者,其中16%(n = 16)被归类为“运动组”,84%(n = 82)被归类为“对照组”。与对照组相比(分别为3136(1553 - 4969)ng/mL,p = 0.010;1055(596 - 2019)U/L,p = 0.016),运动组心肌梗死后的峰值-hs-cTnT和峰值-CK浓度较低(分别为941(645 - 2925)ng/mL;477(346 - 1402)U/L)。在随访期间,两组之间未发现显著差异。

结论

运动参与与STEMI后较低的心脏生物标志物峰值浓度相关。这些数据可为运动训练对心血管健康的益处提供进一步支持。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7488/10106052/0fbf1ac9394b/bmjsem-2022-001488f01.jpg

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