European Journal of Epidemiology

, Volume 26, Issue 2, pp 109–116

Long-term trajectory of leisure time physical activity and survival after first myocardial infarction: a population-based cohort study

  • Yariv Gerber
  • Vicki Myers
  • Uri Goldbourt
  • Yael Benyamini
  • Mickey Scheinowitz
  • Yaacov Drory
Cardiovascular Disease

DOI: 10.1007/s10654-010-9523-8

Cite this article as:
Gerber, Y., Myers, V., Goldbourt, U. et al. Eur J Epidemiol (2011) 26: 109. doi:10.1007/s10654-010-9523-8


The benefits of leisure time physical activity (LTPA) in cardiovascular prevention are well established. While cardiac rehabilitation programmes have been demonstrated as improving myocardial infarction (MI) prognosis, the strength of the association between LTPA and post-MI survival has yet to be quantified. We evaluated long-term survival after MI of inactive, irregularly active, and regularly active patients and examined trajectories of LTPA and their relationship to mortality risk. Consecutive patients aged ≤65 years (n = 1,521), discharged from 8 hospitals in central Israel after first MI in 1992–1993, were followed through 2005. Extensive clinical and sociodemographic data, including self-reported LTPA habits, were obtained at baseline and at 4 subsequent interviews. Pre-MI inactive patients (54%) had lower socioeconomic status, higher prevalence of risk factors and comorbidities and more severe MI. The point prevalence rate of regular LTPA at all follow-up interviews was approximately 40% and 18% were regularly active throughout the entire follow-up. Over a median follow-up of 13.2 years, 427 deaths occurred. After multivariable adjustment, no association was observed between pre-MI LTPA and death. However, with LTPA categories modelled as time-dependent variables, providing an estimation of cumulative assessment and accounting for changes in LTPA post-MI, a strong inverse graded association was revealed (multivariable-adjusted hazard ratios, 0.56 [95% CI: 0.42–0.74] for regular and 0.71 [95% CI: 0.54–0.95] for irregular activity vs. none). Similar estimates were obtained among pre-MI sedentary patients. In summary, after MI, regularly active patients had about half the risk of dying compared with inactive patients, irrespective of pre-MI habits.


Leisure time physical activityMyocardial infarctionSecondary preventionLongitudinal studyEpidemiologyLong-term follow-upSurvival



Acute coronary syndromes


Coronary artery bypass graft


Coronary heart disease


Confidence interval


Cardiovascular disease


Hazard ratio


Leisure time physical activity


Myocardial infarction


Percutaneous transluminal coronary angioplasty


Socioeconomic status

Copyright information

© Springer Science+Business Media B.V. 2010

Authors and Affiliations

  • Yariv Gerber
    • 1
  • Vicki Myers
    • 1
  • Uri Goldbourt
    • 1
    • 5
  • Yael Benyamini
    • 3
  • Mickey Scheinowitz
    • 4
    • 5
  • Yaacov Drory
    • 2
  1. 1.Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Medical SchoolTel Aviv UniversityRamat Aviv, Tel AvivIsrael
  2. 2.Department of Rehabilitation, Sackler Medical SchoolTel Aviv UniversityTel AvivIsrael
  3. 3.Bob Shapell School of Social WorkTel Aviv UniversityTel AvivIsrael
  4. 4.Department of Biomedical EngineeringTel Aviv UniversityTel AvivIsrael
  5. 5.Neufeld Cardiac Research InstituteSheba Medical CenterTel-HashomerIsrael