Physical Activity and Cardiac Self-Efficacy Levels During Early Recovery After Acute Myocardial Infarction

Abstract Background Regenerative therapies offer new approaches to improve cardiac function after acute ST-elevation myocardial infarction (STEMI). Mobilization of stem cells and homing within the infarcted area have been identified as the key mechanisms for successful treatment. Application of granulocyte-colony stimulating factor (G-CSF) is the least invasive way to mobilize stem cells while DDP4-inhibitor facilitates homing via stromal cell-derived factor 1 alpha (SDF-1α). Dutogliptin, a novel DPP4 inhibitor, combined with stem cell mobilization using G-CSF significantly improved survival and reduced infarct size in a murine model. Purpose We initiated a phase II, multicenter, randomized, placebo-controlled efficacy and safety study (N=140) analyzing the effect of combined application of G-CSF and dutogliptin, a small molecule DPP-IV-inhibitor for subcutaneous use after acute myocardial infarction. Methods The primary objective of the study is to evaluate the safety and tolerability of dutogliptin (14 days) in combination with filgrastim (5 days) in patients with STEMI (EF <45%) following percutaneous coronary intervention (PCI). Preliminary efficacy will be analyzed using cardiac magnetic resonance imaging (cMRI) to detect >3.8% improvement in left ventricular ejection fraction (LV-EF). 140 subjects will be randomized to filgrastim plus dutogliptin or matching placebos. Results Baseline characteristics of the first 26 patients randomized (24 treated) in this trial reveal a majority of male patients (70.8%) and a medium age of 58.4 years (37 to 84). During the 2-week active treatment period, 35 adverse events occurred in 13 patients, with 4 rated as serious (hospitalization due to pneumonia N=3, hospitalization due to acute myocardial infarction N=1), and 1 adverse event was rated as severe (fatal pneumonia), 9 moderate, and 25 as mild. 6 adverse events were considered possibly related to the study medication, including cases of increased hepatic enzymes (N=3), nausea (N=1), subcutaneous node/suffusion (N=1) and syncope (N=1). Conclusions Our data demonstrate that the combined application of dutogliptin and G-CSF appears to be safe on the short term and feasible after acute myocardial infarction and may represent a new therapeutic option in future. Funding Acknowledgement Type of funding source: Other. Main funding source(s): This research is funded by the sponsor RECARDIO, Inc., 1 Market Street San Francisco, CA 94150, USA. RECARDIO Inc. is funding the complete study. The Scientific Board of RECARDIO designed the study. Data Collection is at the participating sites. Interpretation of the data by the Scientific Board and Manuscript written by the authors and approved by the Sponsor

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Sex Differences in Perceived Stress and Early Recovery in Young and Middle-Aged Patients With Acute Myocardial Infarction

Circulation ◽

10.1161/circulationaha.114.012826 ◽

2015 ◽

Vol 131 (7) ◽

pp. 614-623 ◽

Cited By ~ 58

Author(s):

Xiao Xu ◽

Haikun Bao ◽

Kelly Strait ◽

John A. Spertus ◽

Judith H. Lichtman ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Sex Differences ◽

Perceived Stress ◽

Middle Aged ◽

Early Recovery ◽

Aged Patients

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Relation of leisure-time physical activity and cardiorespiratory fitness to the risk of acute myocardial infarction in men

Journal of Emergency Medicine ◽

10.1016/0736-4679(95)90322-4 ◽

1995 ◽

Vol 13 (1) ◽

pp. 123-124

Author(s):

Marc David Taub

Keyword(s):

Physical Activity ◽

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Cardiorespiratory Fitness ◽

Leisure Time ◽

Leisure Time Physical Activity

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Lyubertsy Study of mortality in patients with acute myocardial infarction (LIS): the analysis of anamnestic predictors of in-hospital mortality

CARDIOVASCULAR THERAPY AND PREVENTION ◽

10.15829/1728-8800-2012-1-45-48 ◽

2012 ◽

Vol 11 (1) ◽

pp. 45-48 ◽

Cited By ~ 1

Author(s):

S. Yu. Martsevich ◽

M. L. Ginsburg ◽

N. P. Kutishenko ◽

A. D. Deev ◽

A. V. Fokina ◽

...

Keyword(s):

Physical Activity ◽

Diabetes Mellitus ◽

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Psychosocial Risk ◽

Hospital Death ◽

Hospitalised Patients ◽

District Hospitals ◽

The Russian Federation ◽

Age And Sex

Aim. To identify the main anamnestic predictors of mortality in the acute phase of acute myocardial infarction (AMI). Material and methods. The study included all patients admitted to Lyubertsy District hospitals and diagnosed with AMI (n=1133). Results. Out of 1133 hospitalised patients, 172 died in the hospital; in-hospital lethality was 15,2%. Mean age of diseased patients was significantly higher than that in those survived. The risk of in-hospital death was significantly and independently associated with older age (relative risk 1,07). After adjustment for age and sex, other independent predictors of in-hospital AMI death included diabetes mellitus (DM), low physical activity, and selected psychosocial factors. Conclusion. The in-hospital lethality levels, observed in the LIS Study, were typical for the Russian Federation. The main anamnestic predictors of in-hospital death were low physical activity, DM, and psychosocial risk factors.

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Abstract P274: Physical Activity Patterns and Determinants Following Acute Myocardial Infarction: Insights From the VIRGO Study (Variation in Recovery: Role of Gender on Outcomes of Young Acute Myocardial Infarction Patients)

Circulation ◽

10.1161/circ.131.suppl_1.p274 ◽

2015 ◽

Vol 131 (suppl_1) ◽

Author(s):

Karl E Minges ◽

Kelly M Strait ◽

Sarah Camhi ◽

Judith H Lichtman ◽

Rachel P Dreyer ◽

...

Keyword(s):

Physical Activity ◽

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Activity Patterns ◽

Estimating Equation ◽

Vigorous Activity ◽

Targeted Interventions ◽

Factors Associated ◽

Wide Range ◽

Over Time

Introduction: Despite the benefits of participation in regular physical activity (PA) following acute myocardial infarction (AMI), little is known about the habitual patterns of PA for young AMI patients, especially expanding beyond findings for those engaged in cardiac rehabilitation. We assessed patterns and determinants in levels of PA over a period of 12-months following AMI. Methods: A 2:1 (women:men) observational study design enrolled 3,572 AMI patients (2,397 women, 67.1%) aged 18-55 years from 103 US, 24 Spanish, and 3 Australian hospitals (2008-2012). Data were obtained by medical record abstraction and patient interviews at baseline (pre-AMI), 1- and 12-months post-AMI. Patients were assigned to AHA defined levels of PA based on self-reported frequency, duration, and intensity, as follows: Active (≥ 150 min/wk moderate or ≥ 75 min/wk vigorous activity), Insufficient (10-149 min/wk moderate or 10-74 min/wk vigorous activity), or Inactive (< 10 min/wk moderate or vigorous activity). We used a generalized estimating equation model to examine the factors associated with insufficient/inactive PA levels over time. Results: At baseline, 1- and 12-months post-AMI, 36.7%, 37.6%, and 40.0% of patients were considered active. There were 27 PA patterns observed from baseline to 12-months (Table). The most frequent were those with no change in PA over time (14% staying active, 7% insufficient, and 13% inactive). Additionally, 25% of patients had an increase (at least a one category change) in PA, while 19% had a decrease between baseline and 12-months post-AMI. Female sex, non-white race, non-active workplaces, smoking, diabetes, hypertension, and obesity were independently associated with being insufficient/inactive over time (all p<.05). Conclusions: Despite clinical recommendations, young adults recovering from AMI experience a wide range of PA patterns. By identifying factors associated with insufficient/inactive PA during recovery, targeted interventions can be introduced prior to hospital discharge.

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