The association between physical activity, diabetes mellitus (DM), and long-term acute coronary syndrome (ACS) prognosis was evaluated. The GREECS study included 2,172 consecutive ACS patients from six Greek hospitals (2003–2004). In 2013–2014, a 10-year follow up was performed with 1,918 patients. Physical activity was categorized in never, rarely (monthly basis), 1–2 and ≥ 3 times/week. Multi-adjusted analysis revealed that 1–2 and ≥ 3 times/week vs. no physical activity had a protective effect on ACS incidence (OR = 0.63 95% CI 0.38, 1.05) and (OR = 0.63 95% CI 0.40, 0.99) respectively, only in patients without prior baseline CVD event. In a subgroup analysis, with DM as strata in these patients, engagement in physical activity (i.e., 1–2 times/week) had a significant protective effect among patients with diabetes (OR = 0.51, 95% CI 0.27, 0.96, p = .037). These findings revealed the beneficial role of exercise in secondary ACS prevention, even in DM patients. Public health-oriented policies should incorporate regular physical activity as a key protective factor in disease prognosis.
Papataxiarchis, Panagiotakos, Notara, and Kouvari are with the Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece. Kogias is with the Cardiology Clinic, General Hospital of Karditsa, Karditsa, Greece. Stravopodis is with the Cardiology Clinic, General Hospital of Zakynthos Island, Greece. Papanagnou is with the Cardiology Clinic, General Hospital of Lamia, Lamia, Greece. Zombolos is with the Cardiology Clinic, General Hospital of Kalamata, Kalamata, Greece. Mantas is with the Cardiology Clinic, General Hospital of Chalkida, Chalkida, Greece. Pitsavos is with the First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece.