Page 32 - Physical activity in recipients of solid organ transplantation - Edwin J. van Adrichem

Chapter 2
Table 4.
Mediation e
activity and cardiovascular mortality.

ect of cardiac markers on the association between physical
Beta [95% CI, bias corrected]
Cardiovascular mortality
Proportion mediated
Unadjusted
MR-proANP
Indirect e ect
Total e ect
NT-proBNP
Indirect e ect
Total e ect Hs-TnT
Indirect e ect
MR-proANP
Indirect e ect
Total e ect
NT-proBNP
Indirect e ect
Total e ect Hs-TnT
Indirect e ect
-0.08 [-0.13; -0.05] 25% -0.34 [-0.46; -0.22]
-0.13 [-0.18; -0.08] 41% -0.31 [-0.42; -0.19]
-0.09 [-0.14; -0.06] 30%
-0.05 [-0.10; -0.02] 21% -0.26 [-0.38; -0.11]
-0.07 [-0.12; -0.04] 33% -0.22 [-0.34; -0.07]
-0.05 [-0.09; -0.02] 22%
Total e
Adjusted*

ect
-0.31 [-0.42; -0.18]
Total e

ect
*Adjusted mediation models included gender, age, and eGFR. CI, Con
-0.23 [-0.35; -0.09]
Physical activity level as log2 transformed MET-min/day, cardiac markers are log transformed as well.

dence Interval; MR-proANP,
mid-regional pro-atrial natriuretic peptide; NT-proBNP, N-terminal-pro brain natriuretic peptide; Hs-
TnT, high sensitive troponine T; eGFR, estimated glomerular

ltration rate.

e levels of all cardiac markers were highest in the low PA group and lowest in the
high PA group.

erefore, we expected the cardiac markers to have a confounding e

ect in
the association between PA and mortality. Nevertheless, the association between PA and
both CV and all-cause mortality remained prominent after adjustment for these cardiac
markers.
comorbidity.

is observation discredits the notion that the amount of PA that is performed is
merely a proxy for cardiovascular health. Instead, these associations show that a higher level
of PA is linked to improved survival even in patients with notable cardiovascular

ese

ndings with the use of quantitative measures of cardiac damage accord
with results of the previous analyses that used more surrogate measures of CV risk such as
a history of CV-disease, components of the metabolic syndrome, and Framingham risk
score factors.7

is emphasizes that PA is a potential method for modifying cardiovascular
30.