Evidence map›Paper›PMID 40782106›Full record

ArticleJACC. Asia2025

Elevated Exercise Capacity Mitigates Atrial Fibrillation Incidence and Major Cardiovascular Outcomes: A Decade-Long Cohort Study.

Chi-Ting Lu, Ching-Wei Lee, Wei-Ming Huang, Wen-Chung Yu, Hao-Min Cheng, Chern-En Chiang, Chen-Huan Chen, Shih-Hsien Sung

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in JACC. Asia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Chi-Ting LuDepartment of Medicine, Taipei Veterans General Hospital Taoyuan Branch, Taoyuan, Taiwan (R.O.C.); Institute of Emergency and Critical Care Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan (R.O.C.).
Ching-Wei LeeCardiovascular Research Center, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan (R.O.C.); Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan (R.O.C.).
Wei-Ming HuangCardiovascular Research Center, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan (R.O.C.); Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan (R.O.C.).
Wen-Chung YuCardiovascular Research Center, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan (R.O.C.); Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan (R.O.C.).
Hao-Min ChengCardiovascular Research Center, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan (R.O.C.); Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan (R.O.C.); Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan.
Chern-En ChiangCardiovascular Research Center, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan (R.O.C.); Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan (R.O.C.); General Clinical Research Center, Taipei Veterans General Hospital, Taipei, Taiwan (R.O.C.).
Chen-Huan ChenCardiovascular Research Center, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan (R.O.C.).
Shih-Hsien SungInstitute of Emergency and Critical Care Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan (R.O.C.); Cardiovascular Research Center, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan (R.O.C.); Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan (R.O.C.); General Clinical Research Center, Taipei Veterans General Hospital, Taipei, Taiwan (R.O.C.). Electronic address: mr.sungsh@nycu.edu.tw.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAtrial fibrillation (AF) increases cardiovascular risks and reduces quality of life. Although impaired physical activity has correlated with incident AF, the impacts of exercise capacity and blood pressure changes during exercise on AF development remain unclear.

objectivesThe purpose of this study was to evaluate the association between exercise capacity and AF incidence and its effects on major adverse cardiovascular events (MACE).

methodsWe conducted a retrospective analysis using a prospectively maintained administrative database of patients undergoing exercise treadmill testing between 2003 and 2012. Blood pressure measurements at baseline, peak exercise, and recovery were recorded. Participants were followed for new-onset AF and MACE.

resultsAmong 15,450 subjects (median follow-up: 9.1 years; IQR: 7.0-11.5 years), 515 (3.3%) developed AF. Peak METS (pMETs) independently predicted a lower risk of incident AF (HR: 0.92; 95% CI: 0.88-0.97), after adjusting for confounders. Cubic spline analysis revealed a continuous inverse association between pMETs and incident AF. This association was stronger in older adults and those without chronotropic incompetence. Although incident AF increased the risks of ischemic stroke and MACE, higher pMETs independently reduced the risks of ischemic stroke (HR: 0.88; 95% CI: 0.83-0.94) and MACE (HR: 0.86; 95% CI: 0.84-0.88), even after adjusting for incident AF as a time-dependent variable. Additionally, diastolic blood pressure during recovery independently also correlated with incident AF and ischemic stroke.

conclusionsHigher exercise capacity was associated with a lower AF incidence and reduced risks of ischemic stroke and MACE, reinforcing the prognostic value of cardiorespiratory fitness in AF prevention and cardiovascular risk reduction.

Indexed as

atrial fibrillationcardiorespiratory fitnessexercise capacityexercise treadmill testischemic strokemajor adverse cardiovascular events

Identifiers

PMID40782106
PMCPMC12790084

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.