{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T23:26:00Z","timestamp":1791588360661,"version":"4.3.4"},"reference-count":43,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T00:00:00Z","timestamp":1778803200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Oradea"},{"id":[{"id":"https:\/\/ror.org\/00wzhv093","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: The extent of coronary artery disease (CAD) is a major determinant of prognosis in patients with myocardial infarction (MI). While structured exercise is known to be cardioprotective, the association between habitual daily physical activity and angiographic CAD extension remains insufficiently characterized. Methods: In this prospective observational study, 269 patients were hospitalized with acute MI underwent coronary angiography. Habitual daily physical activity during the four weeks preceding admission was assessed using 10-point self-reported daily preadmission effort questions to help the patients to report a final effort score. CAD extension was classified as single-, double- or triple-vessel disease. Differences in daily effort across CAD categories were evaluated using the Kruskal\u2013Wallis test. Independent predictors of CAD extension were identified using ordinal logistic regression adjusted for age, sex, smoking, hypertension, diabetes mellitus, hyperlipidemia and body mass index. Results: Daily preadmission effort decreased progressively with increasing CAD severity (mean scores: 7.44 in single-vessel, 4.93 in double-vessel and 3.69 in triple-vessel disease; p &lt; 0.0001). In multivariable ordinal logistic regression analysis, older age, hypertension, diabetes mellitus and hyperlipidemia were independently associated with greater CAD extension. Higher daily preadmission effort was strongly and independently associated with lower CAD severity; each one-point increase in effort score was associated with a 46% reduction in the odds of more extensive CAD (odds ratio 0.54, 95% confidence interval 0.45\u20130.64; p &lt; 0.0001). Conclusions: Greater habitual daily physical activity prior to myocardial infarction is independently associated with less extensive coronary artery disease. Assessment of daily preadmission effort may provide clinically useful information regarding coronary disease burden and highlights the potential importance of everyday physical activity in cardiovascular prevention. These findings should be interpreted with caution given the use of a non-validated, self-reported measure of physical activity and the observational study design.<\/jats:p>","DOI":"10.3390\/jcm15103814","type":"journal-article","created":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T14:19:29Z","timestamp":1778854769000},"page":"3814","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Self-Reported Habitual Daily Physical Activity as an Independent Predictor of Coronary Artery Disease Extension in Patients with Myocardial Infarction: A Prospective Observational Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-0855-938X","authenticated-orcid":false,"given":"Corina","family":"Cinezan","sequence":"first","affiliation":[{"name":"Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania"},{"name":"Clinical County Emergency Hospital Bihor, 410169 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Luiza","family":"Hiceag","sequence":"additional","affiliation":[{"name":"Cardiology Department, Rehabilitation Hospital, 400347 Cluj-Napoca, Romania"},{"name":"Cardiology Department, Municipal Hospital Aiud, 515200 Aiud, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,15]]},"reference":[{"key":"ref_1","unstructured":"Roth, G.A., Sidiq, M., Halder, P., and Sahu, S.H. (2025). Global, Regional and National Burden of Cardiovascular Diseases and Risk Factors in 204 Countries and Territories, 1990\u20132023. SSRN."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/S0140-6736(16)30677-8","article-title":"Acute myocardial infarction","volume":"389","author":"Reed","year":"2017","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2053","DOI":"10.1056\/NEJMra1606915","article-title":"Acute myocardial infarction","volume":"376","author":"Anderson","year":"2017","journal-title":"N. Engl. J. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1001\/jama.2022.0358","article-title":"Diagnosis and treatment of acute coronary syndromes","volume":"327","author":"Bhatt","year":"2022","journal-title":"JAMA"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2004","DOI":"10.1056\/NEJMra1216063","article-title":"Mechanisms of acute coronary syndromes and their implications for therapy","volume":"368","author":"Libby","year":"2013","journal-title":"N. Engl. J. Med."},{"key":"ref_6","first-page":"E891","article-title":"Contemporary diagnosis and management of patients with myocardial infarction in the absence of obstructive coronary artery disease: A scientific statement from the American Heart Association","volume":"139","author":"Jneid","year":"2019","journal-title":"Circulation"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1754","DOI":"10.1001\/jama.2014.14681","article-title":"Nonobstructive coronary artery disease and risk of myocardial infarction","volume":"312","author":"Maddox","year":"2014","journal-title":"JAMA"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/j.jcmg.2017.08.026","article-title":"The coronary artery disease\u2013reporting and Data System (CAD-RADS)","volume":"11","author":"Xie","year":"2018","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1093\/eurheartj\/ehw548","article-title":"Prognostic assessment of stable coronary artery disease as determined by coronary computed tomography angiography: A Danish multicentre cohort study","volume":"38","author":"Nielsen","year":"2016","journal-title":"Eur. Heart J."},{"key":"ref_10","first-page":"e18","article-title":"2021 ACC\/AHA\/SCAI Guideline for Coronary Artery Revascularization: A Report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"145","author":"Lawton","year":"2022","journal-title":"Circulation"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1091","DOI":"10.1016\/j.jacc.2022.07.004","article-title":"Exercise for primary and secondary prevention of cardiovascular disease","volume":"80","author":"Tucker","year":"2022","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e495","DOI":"10.1161\/CIR.0000000000000559","article-title":"Routine assessment and promotion of physical activity in healthcare settings: A scientific statement from the American Heart Association","volume":"137","author":"Lobelo","year":"2018","journal-title":"Circulation"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"3053","DOI":"10.1016\/j.jacc.2018.10.025","article-title":"Reprint of: Promoting physical activity and exercise","volume":"72","author":"Fletcher","year":"2018","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e030583","DOI":"10.1161\/JAHA.123.030583","article-title":"Changes in physical activity and incidence of nonfatal cardiovascular events in 47153 survivors of myocardial infarction","volume":"12","author":"Hambraeus","year":"2023","journal-title":"J. Am. Heart Assoc."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1729","DOI":"10.1249\/MSS.0000000000002309","article-title":"Physical activity and mortality among male survivors of myocardial infarction","volume":"52","author":"Li","year":"2020","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e010108","DOI":"10.1161\/JAHA.118.010108","article-title":"Increased physical activity post\u2013myocardial infarction is related to reduced mortality: Results from the SWEDEHEART Registry","volume":"7","author":"Ekblom","year":"2018","journal-title":"J. Am. Heart Assoc."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1690","DOI":"10.1016\/j.jacc.2022.02.036","article-title":"Systematic review of physical activity trajectories and mortality in patients with coronary artery disease","volume":"79","author":"Wilhelm","year":"2022","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"774","DOI":"10.1136\/bjsports-2024-108923","article-title":"Longitudinal increase in physical activity and adverse cardiovascular outcomes following the diagnosis of acute coronary syndrome","volume":"59","author":"Cho","year":"2025","journal-title":"Br. J. Sports Med."},{"key":"ref_19","first-page":"E117","article-title":"Supporting physical activity in patients and populations during life events and transitions: A scientific statement from the American Heart Association","volume":"145","author":"Jerome","year":"2022","journal-title":"Circulation"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2259","DOI":"10.1161\/01.cir.0000435708.67487.da","article-title":"Guide to the assessment of Physical Activity: Clinical and Research Applications","volume":"128","author":"Strath","year":"2013","journal-title":"Circulation"},{"key":"ref_21","unstructured":"World Health Organization (2000). Obesity: Preventing and Managing the Global Epidemic, World Health Organization. WHO Technical Report Series 894."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Yang, L., Zheng, B., and Gong, Y. (2025). Global, regional and national burden of ischemic heart disease and its attributable risk factors from 1990 to 2021: A systematic analysis of the global burden of disease study 2021. BMC Cardiovasc. Disord., 25.","DOI":"10.1186\/s12872-025-05022-x"},{"key":"ref_23","unstructured":"GBD 2023 Causes of Death Collaborators (2025). Global burden of 292 causes of death in 204 countries and territories and 660 subnational locations, 1990\u20132023: A systematic analysis for the Global Burden of Disease Study 2023. Lancet, 406, 1811\u20131872."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1270","DOI":"10.1249\/MSS.0000000000001939","article-title":"Physical activity, all-cause and cardiovascular mortality and cardiovascular disease","volume":"51","author":"Kraus","year":"2019","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"979","DOI":"10.1136\/bjsports-2022-105669","article-title":"Non-occupational physical activity and risk of cardiovascular disease, cancer and mortality outcomes: A dose\u2013response meta-analysis of large prospective studies","volume":"57","author":"Garcia","year":"2023","journal-title":"Br. J. Sports Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2643","DOI":"10.1016\/S0140-6736(17)31634-3","article-title":"The effect of physical activity on mortality and cardiovascular disease in 130,000 people from 17 high-income, middle-income and low-income countries: The Pure Study","volume":"390","author":"Lear","year":"2017","journal-title":"Lancet"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.jcct.2019.02.001","article-title":"Relationship of exercise to coronary artery disease extent, severity and plaque type: A coronary computed tomography angiography study","volume":"13","author":"Feuchtner","year":"2019","journal-title":"J. Cardiovasc. Comput. Tomogr."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1016\/0735-1097(93)90051-2","article-title":"Various intensities of leisure time physical activity in patients with coronary artery disease: Effects on cardiorespiratory fitness and progression of coronary atherosclerotic lesions","volume":"22","author":"Hambrecht","year":"1993","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1016\/j.jcct.2024.03.011","article-title":"Self-reported exercise activity influences the relationship between coronary computed tomography angiographic finding and mortality","volume":"18","author":"Natanzon","year":"2024","journal-title":"J. Cardiovasc. Comput. Tomogr."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"101044","DOI":"10.1016\/j.ajpc.2025.101044","article-title":"The influence of high exercise levels on the coronary atherosclerosis profile by computed tomography angiography and outcomes","volume":"23","author":"Feuchtner","year":"2025","journal-title":"Am. J. Prev. Cardiol."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Dias, A.R.L., Antonio, E.L., de Oliveira, H.A., Teixeira, I.L.A., Seibt, L.E., and Serra, A.J. (2025). Prior Aerobic Exercise Training Fails to Confer Cardioprotection Under Varying Exercise Volumes in Early Post-Infarction Cardiac Remodeling in Female Rats. Biomedicines, 13.","DOI":"10.3390\/biomedicines13092221"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.jacc.2021.10.035","article-title":"Coronary atherosclerotic plaque regression","volume":"79","author":"Lum","year":"2022","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2251","DOI":"10.1249\/MSS.0000000000000672","article-title":"Predictors of beneficial coronary plaque changes after aerobic exercise","volume":"47","author":"Madssen","year":"2015","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_34","first-page":"962","article-title":"Coronary artery calcium in athletes: Friend or foe?","volume":"65","author":"Svensson","year":"2025","journal-title":"J. Sports Med. Phys. Fit."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"120699","DOI":"10.1016\/j.atherosclerosis.2026.120699","article-title":"Exercise training-induced plaque stabilization in rabbits associated with restored \u03b22-adrenergic receptor signaling and reduced ectopic trypsin","volume":"415","author":"Liu","year":"2026","journal-title":"Atherosclerosis"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"e328","DOI":"10.1161\/CIR.0000000000001289","article-title":"Core components of cardiac rehabilitation programs: 2024 update: A scientific statement from the American Heart Association and the American Association of Cardiovascular and pulmonary rehabilitation","volume":"150","author":"Brown","year":"2024","journal-title":"Circulation"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"e215","DOI":"10.1016\/j.jacc.2011.02.011","article-title":"2011 ACCF\/AHA focused update incorporated into the ACC\/AHA 2007 guidelines for the management of patients with unstable angina\/non\u2013st-elevation myocardial infarction","volume":"57","author":"Wright","year":"2011","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1461","DOI":"10.1016\/j.jcmg.2016.12.030","article-title":"Impact of exercise on the relationship between CAC scores and all-cause mortality","volume":"10","author":"Arnson","year":"2017","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"133513","DOI":"10.1016\/j.ijcard.2025.133513","article-title":"Associations between change in moderate-to-vigorous physical activity and sedentary behaviour with risk of recurrent cardiovascular events among individuals with coronary heart disease: A prospective cohort study","volume":"437","author":"Carroll","year":"2025","journal-title":"Int. J. Cardiol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1177\/2047487319871217","article-title":"Relationship between physical activity and long-term outcomes in patients with stable coronary artery disease","volume":"27","author":"Biscaglia","year":"2020","journal-title":"Eur. J. Prev. Cardiol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"35341","DOI":"10.1038\/s41598-025-19419-3","article-title":"Association between physical activity domains and cardiovascular diseases among US adults: Evidence from NHANES 2007\u20132020","volume":"15","author":"Huang","year":"2025","journal-title":"Sci. Rep."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1161\/CIRCULATIONAHA.122.061288","article-title":"Prospective Association of Daily Steps With Cardiovascular Disease: A Harmonized Meta-Analysis","volume":"147","author":"Paluch","year":"2023","journal-title":"Circulation"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1483","DOI":"10.1016\/j.jacc.2023.07.029","article-title":"Relationship of Daily Step Counts to All-Cause Mortality and Cardiovascular Events","volume":"82","author":"Stens","year":"2023","journal-title":"J. Am. Coll. Cardiol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/10\/3814\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T14:34:25Z","timestamp":1778855665000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/10\/3814"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,15]]},"references-count":43,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2026,5]]}},"alternative-id":["jcm15103814"],"URL":"https:\/\/doi.org\/10.3390\/jcm15103814","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,15]]}}}