Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Cardiac Rehabilitation
Need for Systematic Efforts to Modify Health-Related Behaviors After Acute Myocardial Infarction in Korea
Seungwoo ChaJin Joo ParkSunyoung KimHong-Yup AhnKyungdo HanYookyung LeeWon-Seok KimNam-Jong Paik
Author information

2018 Volume 82 Issue 10 Pages 2523-2529


Background: Modification of health-related behaviors may improve clinical outcomes after acute myocardial infarction (AMI), but the need for systematic efforts to modify such behaviors and the estimated effect have not been investigated, especially in Asian populations. The aim of the study was to investigate changes in smoking and physical activity after AMI and their associations with death and recurrent revascularization.

Methods and Results: Using the Korean National Insurance Health Service database, we included 13,452 patients with AMI in 2011, who were stable until 1.5 years on average after onset. Patients were grouped according to their smoking status and physical activity before and after AMI. After AMI, 44.6% of smokers continued smoking and only 11.0% of inactive patients increased their physical activity to a sufficient level. The ‘smoker/smoker’ group and ‘non-smoker/smoker’ group showed higher mortality (hazard ratio (HR): 1.566, 95% confidence interval (CI): 1.192–2.035; HR: 1.785, 95% CI: 1.061–2.815, respectively). On the other hand, the ‘active/active’ group and ‘inactive/active’ group showed less mortality (HR: 0.625, 95% CI: 0.460–0.832; HR: 0.681, 95% CI: 0.438–1.009, respectively) and the ‘inactive/active’ group showed less recurrent revascularization (HR: 0.761, 95% CI: 0.599–0.952).

Conclusions: Smoking cessation and maintaining sufficient physical activity after AMI remain challenging for many Korean patients, and are associated with higher rates of mortality and recurrent revascularization. Systematic nationwide efforts such as cardiac rehabilitation (CR) to change health-related behaviors after AMI are required in Korea.

Information related to the author
Previous article Next article