Rapid improvements in physical (in)activity patterns in patients with myocardial infarction immediately following hospital discharge

Abstract

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): Dutch Heart Foundation. Background Physical activity counselling plays a pivotal role in recovery after myocardial infarction (MI), but little is known about changes in physical activity (PA) and sedentary behaviour (SB) patterns in the acute phase post MI. Purpose This study aimed to objectively assess PA and SB during hospitalisation and during the first week post-discharge and to identify whether potential changes in PA patterns differed based on sex, age, need for coronary artery bypass grafting (CABG), presence of ST-elevated myocardial infarction (STEMI), and level of cardiac anxiety. Methods Consecutively admitted patients hospitalised with an MI were approached to participate in this prospective cohort study. SB, light-intensity PA (LIPA) and moderate-vigorous PA (MVPA) were objectively assessed for 24 h/day during hospitalisation and up to 7 days post-discharge in 165 patients. Changes in PA and SB upon the transition from the hospital to home were evaluated using mixed model analyses and outcomes were stratified for predefined subgroups based on patient characteristics. Results Patients (78% male) were 65±10 years and diagnosed with STEMI (50%) or NSTEMI (50%). Sedentary time was high during hospitalisation (12.6 [11.8-13.7] h/day), but substantially decreased following transition to the home environment (−1.8 (−2.4 to −1.3) h/day) (Central Figure). The number of prolonged sedentary bouts (≥60 min) decreased between hospital and home (−1.6 (95%CI −2.0; −1.2) bouts/day). LIPA (1.1 [0.8-1.6] h/day) and MVPA (0.2 [0.1-0.3] h/day) were low during hospitalisation, but significantly increased following transition to the home environment (LIPA: +1.8 (1.4 to 2.3) h/day; MVPA: +0.4 (0.3 to 0.5) h/day, both p<0.001). Improvements in PA and SB were similar across groups, except for CABG patients who did not alter their PA patterns post-discharge. Conclusions Patients with MI demonstrate high levels of sedentary behaviour and low physical activity volumes during hospitalisation, which immediately improved following discharge at the patient’s home environment.