Effect of Exercise Habit Change on the Risk of Cardiovascular Disease in Patients with Non-Cystic Fibrosis Bronchiectasis

초록

RATIONALE: Subjects with bronchiectasis are at a higher risk of major cardiovascular comorbidities (e.g., myocardial infarction[MI] and stroke). However, currently, there are few evidence-based strategies to prevent the development of cardiovasculardiseases in patients with bronchiectasis. We hypothesized regular exercise habit changes are associated with changes in therisk of developing cardiovascular diseases in patients with bronchiectasis. METHODS: We used Korea National HealthExamination database linked to Korea National Health Insurance Service database. Between 2010 and 2016, there were165,886 patients with newly diagnosed bronchiectasis (defined by ICD-10 codes [J47.0 except E84.0]) without history of MI orstroke, who underwent two consecutive health examinations within two years before and after bronchiectasis diagnosis. Exercisehabits were evaluated using a self-report questionnaire at the time of medical examination. Subjects were classified according tochanges in exercise habits as follows: persistent non-exercisers (33%), exercise dropouts (18%), new exercisers (18%), andexercise maintainers (17%). The primary outcomes were newly diagnosed MI or stroke. Subjects were followed until Dec 2018.RESULTS: During median follow-up of 6.1 years, performing exercise any time before or after bronchiectasis diagnosis wasassociated with a lower risk of MI compared to persistent non-exercising: the adjusted hazard ratios (aHRs) (95% confidenceintervals) were 0.89 (0.82-0.97) for exercise dropouts, 0.83 (0.76-0.90) for new exercisers, and 0.67 (0.61-0.72) for exercisemaintainers (p < 0.001). Similarly, the estimates of aHRs for stroke were 12%-31% lower in subjects who performing exercise:aHRs (95% confidence intervals) were 0.88 (0.80-0.96) for exercise dropouts, 0.78 (0.71-0.86) for new exercisers, and 0.69(0.63-0.75) for exercise maintainers (p < 0.001). CONCLUSION: Regular exercises were associated with lower risk of MI orstrokes in subjecs with bronchiectasis, especially in those who initiated and maintained regular exercises