Introduction and Objective: Patients with diabetes benefit from regular exercise. However, the benefit of exercise in patients with diabetes and myocardial infarction (MI) is less clear. Therefore, we sought to evaluate the differences in mortality risk in patients with diabetes and MI (DMI) at various physical activity levels.Methods: Using data from the 2001 to 2014 annual National Health Interview Survey’s, we created a cohort of patients with (DMI). Physical activity levels were categorized following CDC adult exercise guidelines as inactive, insufficiently active, sufficiently active, and highly active. Information on mortality and follow-up time were from the National Death Index-linked mortality files. After computing mortality rates using life table methods, we determined the independent effect of physical activity categories on death using multivariate Cox proportional hazards models adjusted for age, sex, race, marital status, education, region, smoking status, diet habits, alcohol consumption, and obesity.Results: From 2001 to 2014, there were 421,106 participating U.S. adults, of whom 4,698 had (DMI). Over the follow-up period, 1,631 DMI participants died. The mortality rate (per 1000 person-years) for (DMI) stratified by exercise category were: inactive 89, insufficiently active 62, sufficiently active 50, and highly active 44. When exercise categories were compared amongst (DMI) participants with inactivity as the referent in multivariate Cox regression, the hazard ratio for death was 0.75 (95% CI 0.64, 0.89) for insufficient activity, 0.57 (95% CI 0.46, 0.70) for sufficient activity, and 0.49 (95% CI 0.39, 0.60) for highly active.Conclusion: In this population-based analysis, (DMI) subjects who regularly exercised were at a lower risk of death compared to those who were inactive, with the highest physical activity levels showing the most benefit. Further research is needed to elucidate the mechanisms for the benefit among patients with (DMI).
I. Zahrieh: None. L. Haley: None. A. Nicholson: None. N. Illenberger: None. S. Natarajan: None.
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