The Norwegian Trial of Physical Exercise After Myocardial Infarction

Launched by NORWEGIAN UNIVERSITY OF SCIENCE AND TECHNOLOGY · Oct 30, 2020

Keywords

ClinConnect Summary

NorEx is a large, nationwide study in Norway asking whether a supervised exercise program after a heart attack can lower the chances of dying or having another major heart problem. About 9,700 adults who had a type I myocardial infarction (heart attack) in the past and are now stable will be randomly assigned to one of three groups: (1) a structured physical exercise program with supervision, (2) standard care with general advice to stay active, or (3) an observation group that is followed using national health records without extra contact. The main goal is to see the time until death from any cause, a nonfatal heart attack, or a nonfatal stroke over four years. The study will also follow participants longer (up to 10 years) and look at many other outcomes, including hospital visits, quality of life, mood, sleep, memory, medications, and physical fitness. Participants may use a smartwatch and a mobile app to support the exercise and track activity, and outcomes are checked through nationwide health registries.

Eligibility focuses on adults aged 18 to 79 who had an acute heart attack between 2013 and 2022 and are at least three months past hospitalization, in stable condition, and able to participate in exercise. They must have a Norwegian ID, be able to communicate in Norwegian, and consent to participate. Exclusions include people who are already very physically active, planning endurance competitions, cognitive or serious health problems that make exercise unsafe, kidney failure requiring dialysis, living in a nursing home, or participation in another exercise trial. If you join, you’d receive a clearly defined, supervised exercise plan with weekly minutes and intensity, plus trainer support and access to wearable tech, with follow-up for several years to learn whether this approach improves long-term heart health. Results are not available yet; the study started in 2020 and is expected to continue for several years.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • 1. Hospitalized in a Norwegian hospital with an acute myocardial infarction (Type I) during 2013-2022. Patients are included minimum 3 months after hospitalization when they are in a stable clinical condition.
• • 2. Norwegian national identification number
• • 3. Able to communicate in Norwegian or other Scandinavian language
• • 4. Being able to be physically active according to study protocol, as determined by study personnel.
• • 5. Signed informed consent.
• Exclusion criteria:
• • 1. Persons who already participate in physical activity at a similar or higher level than what is prescribed for the intervention group, as determined by study personnel.
• • 2. Participating or plans to participate in endurance sport competitions.
• • 3. Expected to emigrate during the study
• • 4. Cognitive impairment/dementia.
• • 5. Alcohol or drug abuse, or serious psychiatric disease.
• • 6. Known cardiac disease that may represent a contraindication for moderate or high-intensity physical activity, such as symptomatic valvular heart disease, hypertrophic cardiomyopathy, uncontrolled hypertension, in-compensated heart failure, serious arrythmia not under control after treatment, pulmonary hypertension, significant angina after revascularization and optimal drug treatment.
• • 7. Renal insufficiency requiring dialysis.
• • 8. Any end-stage somatic disease with short life expectancy or that is expected to interfere with the participants' ability to comply with the study protocol, such as advanced cancer, chronic lung disease with exacerbations, or other disease, as determined by study personnel.
• • 9. Inability to comply with the study protocol due to any physical disability, somatic disease or mental problem, as determined by study personnel.
• • 10. Residing in nursing home or other institution.
• • 11. Participation in another trial with exercise as an intervention modality.