Accelerometer-measured moderate-to-vigorous physical activity patterns and mortality among individuals with venous thromboembolism: a prospective cohort study from the UK Biobank

Although the “weekend warrior” activity pattern has been associated with lower mortality in the general population, whether it is associated with long-term outcomes after venous thromboembolism (VTE) remains unclear. In this prospective analysis, we examined the association between patterns of moderate‑to‑vigorous physical activity (MVPA) and mortality among individuals with VTE. This prospective study included 2,918 UK Biobank participants with prior VTE and valid wrist accelerometer recordings. We categorized participants according to MVPA volume and distribution as insufficiently active (< 150 min/week MVPA), weekend warriors (WW; ≥150 min/week of MVPA with ≥ 50% of weekly MVPA accumulated during the two most active days), or regularly active (≥ 150 min/week MVPA without meeting the WW criterion). Mortality events and causes were identified through linked registries. Associations with all‑cause, cardiovascular disease (CVD), and cancer mortality were assessed using multivariable Cox proportional hazards models and Kaplan–Meier survival curves. The robustness of the findings was evaluated in subgroup and sensitivity analyses. During a 9.6‑year median follow‑up, 326 participants died, including 91 cardiovascular and 147 cancer deaths. Relative to insufficiently active participants, the regularly active pattern was associated with a lower hazard of all‑cause mortality (hazard ratio [HR], 0.58; 95% confidence interval [CI], 0.40–0.83), and the WW pattern was also associated with lower all-cause mortality (HR, 0.66; 95% CI, 0.50–0.86). The all-cause mortality associations were generally consistent across subgroup and sensitivity analyses. In exploratory secondary cause-specific analyses, WW activity was associated with lower CVD-specific mortality (17 CVD deaths; HR, 0.48; 95% CI, 0.27–0.86), and regular activity was associated with lower cancer-specific mortality (14 cancer deaths; HR, 0.50; 95% CI, 0.28–0.89). In individuals with prevalent VTE, both regularly active and WW patterns meeting guideline-recommended MVPA levels were associated with lower all-cause mortality compared with insufficiently active participants.