DeFina LF, et al. - Investigators assessed the association of high levels of physical activity (≥3000 MET-min/wk) with prevalent coronary artery calcification (CAC). But, they did not find any correlation with increased all-cause or cardiovascular disease (CVD) mortality, even in the presence of clinically significant CAC levels.

Methods

• The Cooper Center Longitudinal Study was a prospective observational study of subjects from the Cooper Clinic, a preventive medicine facility.
• In this study, they included candidates observed from January 13, 1998, to December 30, 2013, with mortality follow-up through December 31, 2014.
• They included 21,758 healthy subjects without prevalent cardiovascular disease (CVD) who reported their physical activity level and underwent CAC scanning.
• They analyzed data from September 26, 2017, to May 2, 2018.
• They categorized the self-reported physical activity into at least 3000 (n = 1561), 1500 to 2999 (n = 3750), and less than 1500 (n = 16 447) metabolic equivalent of task (MET)–minutes/week (min/wk).
• They also categorized CAC scores into at least 100 (n = 5314) and less than 100 (n = 16 444) Agatston units (AU).
• Main outcomes and measures included all-cause and CVD mortality collected from the National Death Index Plus.

Results

• They observed 21,758 male participants with baseline mean (SD) age of 51.7 (8.4) years.
• They noted that males with at least 3000 MET-min/wk were more likely to have prevalent CAC of at least 100 AU (relative risk, 1.11; 95% CI, 1.03-1.20) as compared to those accumulating less physical activity.
• The mean (SD) CAC level was 807 (1120) AU in the group with physical activity of at least 3000 MET-min/wk and CAC of at least 100 AU.
• They observed after a mean (SD) follow-up of 10.4 (4.3) years, 759 all-cause and 180 CVD deaths including 40 all-cause and 10 CVD deaths among those with physical activity of at least 3000 MET-min/wk.
• They found males with CAC of less than 100 AU and physical activity of at least 3000 MET-min/wk were about half as likely to die in comparison to men with less than 1500 MET-min/wk (hazard ratio [HR], 0.52; 95% CI, 0.29-0.91).
• Men with at least 3000 MET-min/wk did not found with a significant increment in all-cause mortality (HR, 0.77; 95% CI, 0.52-1.15) when compared to men with physical activity of less than 1500 MET-min/wk, in the group with CAC of at least 100 AU.
• In the least active men, they noticed candidates with CAC of at least 100 AU were twice as likely to die of CVD as compared to those with CAC of less than 100 AU (HR, 1.93; 95% CI, 1.34-2.78).