Myocardial infarction: staying active reduced the risk of death and reinfarction

Clinical bottom line (level 1b)

  1. One in four patients with a first myocardial infarction died within 7 years, and one in three reinfarcted.
  2. The risk of death was reduced in any patients who were active.
  3. The risk of reinfarction was reduced in patients who maintained or increased activity.
Steffan-Batey et al: Circulation 2000; 102 : 2204-2209
Expires March 2004

The study

Inception cohort study with objective outcomes, adjusted for confounding factors, not validated in an independent set of patients.

Setting: 6 acute hospital, USA

406 patients (aged 25 to 74; mean 59, 63% male) survived a first myocardial infarction for at least 28 days

Excluded if
  • non-Caucasian
  • not interviewed during initial hospital admission, or missing data


Factors studied:
  • age, sex, ethnicity, severity of MI, family hisotry of heart disease, hypertension, diabetes, high serum cholesterol, smoking
  • active, no change compared to sedentary, no change
  • increased activity
  • decreased activity
  • active, no change compared to sedentary, no change
  • increased activity
  • decreased activity


Cox proportional regression analysis was used to adjust for confounding factors.

83% followed for 7 years
Outcomes studied:
  • death
  • reinfarction

The evidence

outcome time to outcome number of patients/total number %
(95% CI)		 NNF
(95% CI)
death 7 years 106/406 26%
(22% to 30%)		 4
(3 to 5)
reinfarction 7 years 150/406 37%
(32% to 42%)		 3
(2 to 3)

prognostic factor for
death 		time to outcome adjusted RR
(95% CI)		 NNF+
(95% CI)
active, no change 7 years 0.21
(0.10 to 0.44) 		3
(3 to 5)
increased activity 7 years 0.11
(0.03 to 0.46) 		3
(3 to 5)
decreased activity 7 years 0.49
(0.26 to 0.90) 		5
(3 to 25)

prognostic factor for
reinfarction 		time to outcome adjusted RR
(95% CI)		 NNF+
(95% CI)
active, no change 7 years 0.40
(0.24 to 0.66) 		5
(4 to 9)
increased activity 7 years 0.22
(0.09 to 0.50) 		4
(3 to 6)
decreased activity 7 years 0.93
(0.59 to 1.42) 		45
(-7 to 8)

    Citation

    1. Steffan-Batey L, Nichaman MZ, GOff DC, et al: change in physical activity and risk of all-cause mortality or reinfarction: the Corpus Christi Heart Project. Circulation 2000; 102 : 2204-2209
    Search Terms:
    Contributor: Chris Ball, March 2002
    Reviewer:

    Clinical Question.
    Patient first myocardial infarction
    Intervention or Exposure exercise
    Outcome death, reinfarction