Systematic Review of Physical Activity Trajectories and Mortality in Patients With Coronary Artery Disease.

Gonzalez-Jaramillo, Nathalia; Wilhelm, Matthias; Arango-Rivas, Ana María; Gonzalez-Jaramillo, Valentina; Mesa-Vieira, Cristina; Minder, Beatrice; Franco, Oscar H; Bano, Arjola (2022). Systematic Review of Physical Activity Trajectories and Mortality in Patients With Coronary Artery Disease. Journal of the American College of Cardiology, 79(17), pp. 1690-1700. Elsevier 10.1016/j.jacc.2022.02.036

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The role of lifestyle physical activity (PA) trajectories in the mortality risk of patients with coronary heart disease (CHD) remains unclear.


The purpose of this study was to determine the association of longitudinal PA trajectories with all-cause and cardiovascular disease (CVD) mortality in patients with CHD.


Longitudinal cohorts reporting the association of PA trajectories with mortality in patients with CHD were identified in April 2021 by searching 5 databases without language restrictions. Published HRs and 95% CIs were pooled using random effects models and bias assessed by Egger regression.


A total of 9 prospective cohorts included 33,576 patients. The mean age was 62.5 years. The maximum follow-up was 15.7 years. All of the studies assessed PA through validated questionnaires, and mortality was well documented. Changes in PA defined 4 nominal PA trajectories. Compared with always-inactive patients, the risk of all-cause mortality was 50% lower in those who remained active (HR: 0.50; 95% CI: 0.39-0.63); 45% lower in those who were inactive but became active (HR: 0.55; 95% CI: 0.44-0.7); and 20% lower in those who were active but became inactive (HR: 0.80; 95% CI: 0.64-0.99). Similar results were observed for CVD mortality, except for the category of decreased activity (HR: 0.91; 95% CI: 0.67-1.24). The overall risk of bias was low. No evidence of publication bias was found. Multiple sensitivity analyses provided consistent results.


This study illustrates how patients with CHD may benefit by preserving or adopting an active lifestyle. The observation that the benefits of past activity can be weakened or lost if PA is not maintained may be confounded by disease progression.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)
13 Central Units > Administrative Director's Office > University Library of Bern

Graduate School:

Graduate School for Health Sciences (GHS)

UniBE Contributor:

Gonzalez Jaramillo, Nathalia, Wilhelm, Matthias, Gonzalez Jaramillo, Valentina, Mesa Vieira, Cristina, Minder, Beatrice, Franco Duran, Oscar Horacio, Bano, Arjola


600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services
000 Computer science, knowledge & systems > 020 Library & information sciences








Pubmed Import

Date Deposited:

29 Apr 2022 09:44

Last Modified:

05 Dec 2022 16:19

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

coronary heart disease lifestyle mortality physical activity survival trajectories




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