Patterns of Sedentary Behavior in The First Month After Acute Coronary Syndrome

Abstract

Sedentary behavior (SED) is a key contributor to cardiovascular disease in the general population. Few data exist on objectively measured SED patterns in acute coronary syndrome (ACS) patients in the first month after an ACS event; a critical period when lifestyle behaviors are reformed. PURPOSE: To characterize SED patterns and their correlates in ACS patients over the first month post-discharge. METHODS: Participants (n = 177) with confirmed ACS (myocardial infarction or unstable angina) from a university hospital in Upper Manhattan were examined. SED was objectively measured for 28-days post-discharge via Actical wrist accelerometry. Group-based modeling at the day-level was used to characterize SED patterns (trajectories) over the 28-days. Logistic regression was used to determine correlates of SED trajectories. Correlates included sociodemographic, hospitalization, physical and psychosocial factors. Models were adjusted for age, sex, race and ethnicity. RESULTS: Participants spent a mean (SD) of 12.3±3.2 hrs/day in SED the first month post-discharge. Three distinct SED trajectory groups were identified (Fig 1). The high SED group (38%) spent a mean (SD) of 15.6±1.3 hrs/day in SED with no change in day-level SED. The moderate SED group (41%) spent a mean (SD) of 11.8±1.2 hrs/day in SED with little change in day-level SED. The low SED group (21%) spent a mean (SD) of 7.6±1.5 hrs/day in SED, with a gradual decline in SED from immediately post-discharge (∼ 9 hrs/day) to 28-days post-discharge (∼ 7 hrs/day). In multivariable models, left ventricular ejection fraction< 40, length of hospital stay and coronary artery bypass grafting were identified as significant correlates of the high SED group (p<0.05 for all). CONCLUSION: ACS survivors accrued alarmingly high volumes of SED during the first month post-discharge, with little to no change in day-level SED over time. ACS survivors with greater disease severity were more likely to accrue higher volumes of SED.Figure 1: Trajectories of sedentary time post-discharge in ACS patients.