Boudon Alex, Locatelli Isabella, Gencer Baris, Carballo David, Klingenberg Roland, Räber Lorenz, Windecker Stephan, Rodondi Nicolas, Lüscher Thomas, Matter Christian M, Mach François, Muller Olivier, Nanchen David
Center for Primary Care and Public Health (Unisanté), University of Lausanne Faculty of Biology and Medicine, Lausanne, Vaud, Switzerland.
Division of Cardiology, Faculty of Medicine, University of Geneva, Geneve, Switzerland.
BMJ Open. 2025 Jan 15;15(1):e088262. doi: 10.1136/bmjopen-2024-088262.
To assess the association between the intensity of statin therapy and the level of physical activity in patients 1 year after an acute coronary syndrome (ACS).
Prospective cohort study from the Special Program University Medicine-Acute Coronary Syndromes.
Four university hospital centres in Switzerland.
2274 patients with a main diagnosis of ACS between 2009 and 2017 who were available for a 1-year follow-up visit 1 year after hospital discharge.
Self-reported physical activity was assessed with the International Physical Activity Questionnaire. The level of physical activity in metabolic equivalent-minutes per week (MET-min/week) was first stratified into sedentary and physically active categories and then analysed continuously among physically active patients. Analyses were performed using a propensity score weighting approach.
One year after ACS, 1222 (53.7%) patients were on high-intensity statin therapy, 890 (39.1%) were on low/moderate-intensity statin therapy and 162 (7.1%) were not on statin therapy. Compared with non-statin users, low-/moderate-intensity statin users and high-intensity statin users were more likely to be physically active than sedentary, with a fully adjusted OR of 2.86 (95% CI 1.12 to 7.26) and 4.52 (95% CI 1.68 to 12.20), respectively. Among physically active patients, physical activity level was similar across all statin user categories, with median levels of 2792.5, 2712.0 and 2839.5 MET-min/week in non-statin, moderate/low-statin and high-statin users, respectively (p=0.307).
One year after ACS, neither low-/moderate-intensity nor high-intensity statin uses were associated with reduced self-reported physical activity compared with non-statin use. The concern that statin therapy may impair physical activity among ACS patients was not confirmed in this study.
评估急性冠状动脉综合征(ACS)患者在发病1年后他汀类药物治疗强度与身体活动水平之间的关联。
来自大学医学-急性冠状动脉综合征特别项目的前瞻性队列研究。
瑞士的四个大学医院中心。
2009年至2017年间主要诊断为ACS且出院1年后可进行1年随访的2274例患者。
采用国际体力活动问卷评估自我报告的身体活动情况。每周代谢当量分钟数(MET-min/周)的身体活动水平首先分为久坐不动和身体活跃两类,然后在身体活跃的患者中进行连续分析。采用倾向评分加权法进行分析。
ACS发病1年后,1222例(53.7%)患者接受高强度他汀类药物治疗,890例(39.1%)接受低/中强度他汀类药物治疗,162例(7.1%)未接受他汀类药物治疗。与未使用他汀类药物的患者相比,低/中强度他汀类药物使用者和高强度他汀类药物使用者身体活跃的可能性高于久坐不动者,完全调整后的比值比分别为2.86(95%CI 1.12至7.26)和4.52(95%CI 1.68至12.20)。在身体活跃的患者中,所有他汀类药物使用者类别之间的身体活动水平相似,未使用他汀类药物、中/低强度他汀类药物和高强度他汀类药物使用者的中位水平分别为2792.5、2712.0和2839.5 MET-min/周(p=0.307)。
ACS发病1年后,与未使用他汀类药物相比,低/中强度和高强度他汀类药物的使用均与自我报告的身体活动减少无关。本研究未证实他汀类药物治疗可能损害ACS患者身体活动的担忧。