Triggering of Acute Coronary Occlusion by Episodes of Vigorous Physical Exertion

Buckley, T; Soo Hoo, SY; Shaw, E; Hansen, PS; Fethney, J; Tofler, GH

Triggering of Acute Coronary Occlusion by Episodes of Vigorous Physical Exertion

Buckley, T Soo Hoo, SY

Shaw, E Hansen, PS Fethney, J Tofler, GH

Permalink

Publication Type:: Journal Article
Citation:: Heart Lung and Circulation, 2019, 28 (12), pp. 1773 - 1779
Issue Date:: 2019-12-01

Closed Access

	Filename	Description	Size
	1-s2.0-S1443950618319693-main.pdf	Published Version	366.1 kB	Adobe PDF	View/Open

Copyright Clearance Process

Recently Added
In Progress
Closed Access

This item is closed access and not available.

Full metadata record

Field	Value	Language
dc.contributor.author	Buckley, T	en_US
dc.contributor.author	Soo Hoo, SY https://orcid.org/0000-0002-0002-0787	en_US
dc.contributor.author	Shaw, E	en_US
dc.contributor.author	Hansen, PS	en_US
dc.contributor.author	Fethney, J	en_US
dc.contributor.author	Tofler, GH	en_US
dc.date.available	2018-11-03	en_US
dc.date.issued	2019-12-01	en_US
dc.identifier.citation	Heart Lung and Circulation, 2019, 28 (12), pp. 1773 - 1779	en_US
dc.identifier.issn	1443-9506	en_US
dc.identifier.uri	http://hdl.handle.net/10453/138365
dc.description.abstract	© 2018 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ) Background: There is increasing recognition that heavy exertion can occasionally trigger an acute myocardial infarction (MI), although some uncertainties exist regarding the link. The primary aim of this study was to compare the relative risk (RR) of MI following vigorous exertion between those with confirmed coronary occlusion and those with a non-occluded culprit artery on acute angiography. Secondary aims were to determine if the risk of coronary occlusion is modified by the type of exercise (dynamic or isometric resistance), the frequency of regular exertion or whether the exertion was emotionally charged. Methods: Seven hundred sixty-two (762) participants with MI (410 with coronary occlusion TIMI 0,1), and 352 (46%) with a non-occluded culprit artery (TIMI 2,3) completed a questionnaire within 4 days of admission, detailing episodes of physical exertion in the 28 hours prior to symptom onset and the usual frequency of such exertion. Exertion exposures within 1 hour prior to symptom onset were compared to subjects’ usual yearly exposure, with case-crossover methodology. Results: The RR of symptom onset following heavy physical exertion level ≥6 (exertion scale 1–8), was higher in those with TIMI 0,1 compared to those with TIMI 2,3 flow (RR 6.30, 95% CI 4.70–8.50 vs 3.93, 2.89–5.30). The increased risk of coronary occlusion following vigorous exertion was observed following both dynamic exertion and isometric resistance, and did not differ between exertion types. The highest risk of coronary occlusion following exertion was observed in those who were sedentary (regular vigorous exertion <1 day weekly) (RR = 77, 95% CI 46–132), whereas in those who frequently perform regular vigorous physical exertion (>4 days weekly), the RR of symptom onset during exertion was significantly lower, RR 2.3 (95% CI 1.5–3.6). There was no significant difference in relative risk based on whether the exertion was reported as emotionally charged. Conclusions: The relative risk that heavy exertion will trigger a non-fatal MI with an occluded artery is greater than for a non-occluded culprit artery. Both dynamic and isometric exertion increase the relative risk of event, while exposure to regular vigorous exertion reduces the relative risk.	en_US
dc.relation.ispartof	Heart Lung and Circulation	en_US
dc.relation.isbasedon	10.1016/j.hlc.2018.11.001	en_US
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject.classification	Cardiovascular System & Hematology	en_US
dc.title	Triggering of Acute Coronary Occlusion by Episodes of Vigorous Physical Exertion	en_US
dc.type	Journal Article
utslib.citation.volume	12	en_US
utslib.citation.volume	28	en_US
utslib.for	1102 Cardiorespiratory Medicine and Haematology	en_US
utslib.for	1117 Public Health and Health Services	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
utslib.copyright.status	closed_access	*
pubs.issue	12	en_US
pubs.publication-status	Published	en_US
pubs.volume	28	en_US

Abstract:

© 2018 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ) Background: There is increasing recognition that heavy exertion can occasionally trigger an acute myocardial infarction (MI), although some uncertainties exist regarding the link. The primary aim of this study was to compare the relative risk (RR) of MI following vigorous exertion between those with confirmed coronary occlusion and those with a non-occluded culprit artery on acute angiography. Secondary aims were to determine if the risk of coronary occlusion is modified by the type of exercise (dynamic or isometric resistance), the frequency of regular exertion or whether the exertion was emotionally charged. Methods: Seven hundred sixty-two (762) participants with MI (410 with coronary occlusion TIMI 0,1), and 352 (46%) with a non-occluded culprit artery (TIMI 2,3) completed a questionnaire within 4 days of admission, detailing episodes of physical exertion in the 28 hours prior to symptom onset and the usual frequency of such exertion. Exertion exposures within 1 hour prior to symptom onset were compared to subjects’ usual yearly exposure, with case-crossover methodology. Results: The RR of symptom onset following heavy physical exertion level ≥6 (exertion scale 1–8), was higher in those with TIMI 0,1 compared to those with TIMI 2,3 flow (RR 6.30, 95% CI 4.70–8.50 vs 3.93, 2.89–5.30). The increased risk of coronary occlusion following vigorous exertion was observed following both dynamic exertion and isometric resistance, and did not differ between exertion types. The highest risk of coronary occlusion following exertion was observed in those who were sedentary (regular vigorous exertion <1 day weekly) (RR = 77, 95% CI 46–132), whereas in those who frequently perform regular vigorous physical exertion (>4 days weekly), the RR of symptom onset during exertion was significantly lower, RR 2.3 (95% CI 1.5–3.6). There was no significant difference in relative risk based on whether the exertion was reported as emotionally charged. Conclusions: The relative risk that heavy exertion will trigger a non-fatal MI with an occluded artery is greater than for a non-occluded culprit artery. Both dynamic and isometric exertion increase the relative risk of event, while exposure to regular vigorous exertion reduces the relative risk.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/138365