{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T12:59:27Z","timestamp":1765889967235,"version":"3.48.0"},"reference-count":41,"publisher":"BMJ","issue":"10","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2015,7,15]]},"published-print":{"date-parts":[[2015,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To identify the role of fitness, fitness change, body mass index and other factors in predicting long-term (&gt;5\u2005years) survival in patients with coronary heart disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cohort study of patients with coronary heart disease recruited from 1 January 1993 to 31 December 2002, followed up to March 2011 (1\u2005day to 18\u2005years 3\u2005months, mean 10.7\u2005years).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>A community-based National Health Service (NHS) cardiac rehabilitation programme serving the Basingstoke and Alton area in Hampshire, UK.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>An unselected cohort of NHS patients, 2167 men and 547 women aged 28\u201388\u2005years, who attended the rehabilitation programme following acute myocardial infarction, an episode of angina or revascularisation, and had a baseline fitness test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>Cardiovascular mortality and all-cause mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A high level of fitness (VO\n                      <jats:sub>2<\/jats:sub>\n                      \u226522\u2005mL\/kg\/min for men, VO\n                      <jats:sub>2<\/jats:sub>\n                      \u226519\u2005mL\/kg\/min for women) at completion of the programme was associated with decreased all-cause death, as was a prescription for statins or aspirin, and female gender. Increase in all-cause mortality was associated with higher age and ACE inhibitors prescription. Higher risk of cardiovascular mortality was associated with increasing age, prescriptions for ACE inhibitor, and diagnosis of myocardial infarction or angina as compared with the other diagnoses.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Prior fitness and fitness improvement are strong predictors of long-term survival in patients who have experienced a cardiac event or procedure. Some secondary prevention medications make a significant contribution to reducing all-cause mortality and cardiovascular mortality in these patients. This study supports public health messages promoting fitness for life.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2015-007772","type":"journal-article","created":{"date-parts":[[2015,10,23]],"date-time":"2015-10-23T11:38:27Z","timestamp":1445600307000},"page":"e007772","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":18,"title":["Fitness predicts long-term survival after a cardiovascular event: a prospective cohort study"],"prefix":"10.1136","volume":"5","author":[{"given":"Martine J","family":"Barons","sequence":"first","affiliation":[{"name":"Complexity Science Centre, University of Warwick, Coventry, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sally","family":"Turner","sequence":"additional","affiliation":[{"name":"Basingstoke Cardiac Rehabilitation Centre, Basingstoke, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas","family":"Parsons","sequence":"additional","affiliation":[{"name":"Warwick Medical School, University of Warwick, Coventry, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frances","family":"Griffiths","sequence":"additional","affiliation":[{"name":"Warwick Medical School, University of Warwick, Coventry, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hugh","family":"Bethell","sequence":"additional","affiliation":[{"name":"Basingstoke & Alton Cardiac Rehabilitation Centre, Basingstoke, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott","family":"Weich","sequence":"additional","affiliation":[{"name":"Warwick Medical School, University of Warwick, Coventry, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margaret","family":"Thorogood","sequence":"additional","affiliation":[{"name":"Warwick Medical School, University of Warwick, Coventry, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2015,10,22]]},"reference":[{"key":"2025121604541138000_5.10.e007772.1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2007.127068"},{"key":"2025121604541138000_5.10.e007772.2","doi-asserted-by":"crossref","unstructured":"Greenhalgh J , Hockenhull J , Rao N , et al . Drug-eluting stents versus bare metal stents for angina or acute coronary syndromes. Cochrane Database Syst Rev 2010;(5):CD004587. doi:10.1002\/14651858.CD004587.pub2","DOI":"10.1002\/14651858.CD004587.pub2"},{"key":"2025121604541138000_5.10.e007772.3","doi-asserted-by":"crossref","unstructured":"Nordmann AJ , Bucher H , Hengstler P , et al . Primary stenting versus primary balloon angioplasty for treating acute myocardial infarction. Cochrane Database Syst Rev 2005;(2):CD005313. doi:10.1002\/14651858.CD005313","DOI":"10.1002\/14651858.CD005313"},{"key":"2025121604541138000_5.10.e007772.4","doi-asserted-by":"crossref","unstructured":"Vale N , Nordmann AJ , Schwartz GG , et al . Statins for acute coronary syndrome. Cochrane Database Syst Rev 2011;(6):CD006870. doi:10.1002\/14651858.CD006870.pub2","DOI":"10.1002\/14651858.CD006870.pub2"},{"key":"2025121604541138000_5.10.e007772.5","doi-asserted-by":"crossref","first-page":"1950","DOI":"10.1016\/j.athoracsur.2012.02.071","article-title":"Impact of functional status on survival after coronary artery bypass grafting in a veteran population","volume":"93","author":"Cervera","year":"2012","journal-title":"Ann Thorac Surg"},{"key":"2025121604541138000_5.10.e007772.6","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1111\/j.1540-8191.2011.01341.x","article-title":"What happens after discharge? An analysis of long-term survival in cardiac surgical patients requiring prolonged intensive care","volume":"27","author":"Elfstrom","year":"2012","journal-title":"J Card Surg"},{"key":"2025121604541138000_5.10.e007772.7","doi-asserted-by":"crossref","first-page":"1943","DOI":"10.1016\/j.athoracsur.2012.02.072","article-title":"Established preoperative risk factors do not predict long-term survival in isolated coronary artery bypass grafting patients","volume":"93","author":"Filardo","year":"2012","journal-title":"Ann Thorac Surg"},{"key":"2025121604541138000_5.10.e007772.8","doi-asserted-by":"crossref","first-page":"76","DOI":"10.3109\/14017431.2011.653824","article-title":"Patients with micro or other myocardial infarctions have equal long-term survival","volume":"46","author":"Grundtvig","year":"2012","journal-title":"Scand Cardiovasc J"},{"key":"2025121604541138000_5.10.e007772.9","first-page":"115","article-title":"Outcome of the HORIZONS-AMI trial: bivalirudin enhances long-term survival in patients with ST-elevation myocardial infarction undergoing angioplasty","volume":"8","author":"Shah","year":"2012","journal-title":"Vasc Health Risk Manag"},{"key":"2025121604541138000_5.10.e007772.10","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.066902"},{"key":"2025121604541138000_5.10.e007772.11","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1016\/j.healthplace.2010.12.007","article-title":"An index of unhealthy lifestyle is associated with coronary heart disease mortality rates for small areas in England after adjustment for deprivation","volume":"17","author":"Scarborough","year":"2011","journal-title":"Health Place"},{"key":"2025121604541138000_5.10.e007772.12","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/eht159"},{"key":"2025121604541138000_5.10.e007772.13","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.705947"},{"key":"2025121604541138000_5.10.e007772.14","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000118498.35499.B2"},{"key":"2025121604541138000_5.10.e007772.15","first-page":"285","article-title":"Coronary rehabilitation in the community","volume":"33","author":"Bethell","year":"1983","journal-title":"J R Coll Gen Pract"},{"key":"2025121604541138000_5.10.e007772.16","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.64.6.370"},{"key":"2025121604541138000_5.10.e007772.17","unstructured":"Turner SC . Relationship of physical fitness, depression and mortality in a cardiac rehabilitation cohort. Warwick Medical School, University of Warwick, 2007."},{"key":"2025121604541138000_5.10.e007772.18","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2007.134338"},{"key":"2025121604541138000_5.10.e007772.19","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2011-300302"},{"key":"2025121604541138000_5.10.e007772.20","doi-asserted-by":"crossref","unstructured":"Heran BS , Chen JM , Ebrahim S , et al . Exercise-based cardiac rehabilitation for coronary heart disease. Cochrane Database Syst Rev 2011;(7):CD001800. doi:10.1002\/14651858.CD001800.pub2","DOI":"10.1002\/14651858.CD001800.pub2"},{"key":"2025121604541138000_5.10.e007772.21","doi-asserted-by":"publisher","DOI":"10.1097\/01.psy.0000146332.53619.b2"},{"key":"2025121604541138000_5.10.e007772.22","doi-asserted-by":"publisher","DOI":"10.1097\/01.psy.0000146294.82810.9c"},{"key":"2025121604541138000_5.10.e007772.23","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3999(01)00296-3"},{"key":"2025121604541138000_5.10.e007772.24","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-4356(96)00271-5"},{"key":"2025121604541138000_5.10.e007772.25","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(73)90502-4"},{"key":"2025121604541138000_5.10.e007772.26","unstructured":"Bruce RA . Exercise testing and exercise training in coronary heart disease. In: Hellerstein HK , eds. Principles in exercise testing. New York, USA: Academic Press, 1973:45\u201361."},{"key":"2025121604541138000_5.10.e007772.27","unstructured":"Astrand PO , Rodahl K . Physiological basis of exercise. In: Text book of work physiology. New York, USA: McGraw-Hill, 1986."},{"key":"2025121604541138000_5.10.e007772.28","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2003.07.028"},{"key":"2025121604541138000_5.10.e007772.29","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000024413.15949.ED"},{"key":"2025121604541138000_5.10.e007772.30","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2013.02.013"},{"key":"2025121604541138000_5.10.e007772.31","unstructured":"Collett D . Modelling survival data in medical research. In: Texts in statistical science. Boca Raton: Chapman & Hall\/CRC, 2003."},{"key":"2025121604541138000_5.10.e007772.32","doi-asserted-by":"crossref","unstructured":"Akaike H . A new look at the statistical model identification. IEEE Trans Automat Control. 1974;19:716\u201323.","DOI":"10.1109\/TAC.1974.1100705"},{"key":"2025121604541138000_5.10.e007772.33","unstructured":"R Development Core Team. R: a language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing, 2011."},{"key":"2025121604541138000_5.10.e007772.34","doi-asserted-by":"crossref","unstructured":"Little RJA , Rubin DA . Statistical analysis with missing data. In: Series in probability and statistics. New Jersey, USA: Wiley-Interscience, 2002.","DOI":"10.1002\/9781119013563"},{"key":"2025121604541138000_5.10.e007772.35","doi-asserted-by":"publisher","DOI":"10.1136\/jech.2011.142976a.18"},{"key":"2025121604541138000_5.10.e007772.36","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2010.196170"},{"key":"2025121604541138000_5.10.e007772.37","unstructured":"Heyward VH . Advance fitness assessment and exercise prescription. 3rd en. Human Kinetics Europe Ltd, 1998."},{"key":"2025121604541138000_5.10.e007772.38","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)69251-9"},{"key":"2025121604541138000_5.10.e007772.39","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcad.2013.09.002"},{"key":"2025121604541138000_5.10.e007772.40","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.114.100065"},{"key":"2025121604541138000_5.10.e007772.41","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2010.10.047"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2015-007772","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T12:54:19Z","timestamp":1765889659000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2015-007772"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,10]]},"references-count":41,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2015,10,22]]},"published-print":{"date-parts":[[2015,10]]}},"alternative-id":["10.1136\/bmjopen-2015-007772"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2015-007772","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"type":"print","value":"2044-6055"},{"type":"electronic","value":"2044-6055"}],"subject":[],"published":{"date-parts":[[2015,10]]}}}