• Adam J Singer, Henry C Thode, W Frank Peacock, Judd E Hollander, Deborah Diercks, Robert Birkhahn, Nathan Shapiro, Ted Glynn, Richard Nowack, Basmah Safdar, Chadwick Miller, Elizabeth Lewandrowski, John Nagurney, and MIDAS Investigators.
• Department of Emergency Medicine, Stony Brook University and Medical Center, Stony Brook, New York 11794-8350, USA.
• J Emerg Med. 2013 Jan 1;44(1):17-22.

BackgroundRegular exercise is thought to be protective against coronary artery disease. As a result, some physicians believe that the likelihood of acute coronary syndrome (ACS) in patients with acute chest pain is reduced in those who exercise regularly. We studied the association between self-reported frequency of exercising and the likelihood of ACS in patients presenting to the Emergency Department (ED) with chest pain.MethodsA multi-center prospective, descriptive, cohort study design was used in ED patients to determine whether the risk of ACS was reduced in patients who self-reported regular exercise.ResultsThere were 1093 patients enrolled. Median (interquartile range) age was 57 (48-67) years; 506 (45.7%) were female. ACS was diagnosed in 248 (22.7%) patients. Patients who did not exercise at least monthly were more likely to be diagnosed with ACS than those who did (129/466 [27.7%] vs. 119/627 [19.0%]; odds ratio 1.63, 95% CI 1.23-2.17). After adjusting for age, gender, body mass index, smoking, and prior history, limited exercise was still associated with ACS (adjusted odds ratio 1.52, 95% CI 1.10-2.10). There was no apparent association between frequency and intensity of exercise and risk of ACS.ConclusionAlthough self-reported frequency of exercise was significantly associated with a decrease in ACS in ED patients with chest pain, it should not be used to exclude ACS in symptomatic ED patients.Copyright © 2013 Elsevier Inc. All rights reserved.

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