The effect of percutaneous coronary intervention on habitual physical activity in older patients.

Sarah J Charman,Joseph R Dunford,Murugapathy Veerasamy,Vijay Kunadian,Louise Quinn,Vincent T Van Hees,Bilal Bawamia,Djordje G Jakovljevic,Michael I Trenell

doi:10.1186/s12872-016-0428-7

Abstract

BackgroundGiven the ongoing burden of cardiovascular disease and an ageing population, physical activity in patients with coronary artery disease needs to be emphasized. This study assessed whether sedentary behaviour and physical activity levels differed among older patients (≥75 years) following percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) consisting of ST-segment elevation myocardial infarction (STEMI) and non STEMI (NSTEMI) versus an elective admission control group of stable angina patients.MethodsSedentary behaviour and physical activity were assessed over a 7-day period using wrist-worn triaxial accelerometers (GENEActiv, Activinsights Ltd, UK) in 58 patients following PCI for, STEMI (n = 20) NSTEMI (n = 18) and stable angina (n = 20) upon discharge from a tertiary centre. Mean ± Standard deviation age was 79 ± 4 years (31% female).ResultsSTEMI and NSTEMI patients spent more time in the low acceleration category (0–40 mg) reflecting sedentary time versus stable angina patients (1298 ± 59 and 1305 ± 66 vs. 1240 ± 92 min/day, p < 0.05). STEMI and NSTEMI patients spent less time in the 40–80 mg acceleration category reflecting low physical activity versus stable angina patients (95 ± 35 and 94 ± 41 vs. 132 ± 50 min/day, p < 0.05). Stable angina patients spent more time in the higher acceleration categories (80–120 and 120–160 mg) and moderate-to-vigorous physical activity (defined as 1 and 5 min/day bouts) versus NSTEMI patients (p < 0.05). For acceleration categories ≥160 mg, no differences were observed.ConclusionsPatients presenting with ACS and undergoing PCI spent more time in sedentary behaviour compared with stable angina patients.

Highlights

Given the ongoing burden of cardiovascular disease and an ageing population, physical activity in patients with coronary artery disease needs to be emphasized
When separated into the three coronary artery disease (CAD) hospitalisation groups, results revealed that only 5% of segment elevation myocardial infarction (STEMI) had a prior percutaneous coronary intervention (PCI) whereas 22% of non STEMI (NSTEMI) and 45% of stable angina patients had a prior PCI, χ2 (2, N = 58) = 8.79, p < 0.05
Prior myocardial infarction was reported in 33% of the sample with 50% of stable angina patients suffering a prior myocardial infarction compared with only 10% of STEMI patients and 39% NSTEMI patients, χ2 (2, N = 58) = 7,71, p < 0.05

Summary

Introduction

Given the ongoing burden of cardiovascular disease and an ageing population, physical activity in patients with coronary artery disease needs to be emphasized. In the UK, cardiovascular disease accounted for 180,000 deaths in 2010, 80,000 of which were caused by coronary artery disease (CAD) [1]. In the USA, cardiovascular disease resulted in 1 in 3 deaths in 2009 [2] Sedentary behaviours, such as the amount of time spent sitting are associated with increased risk of Charman et al BMC Cardiovascular Disorders (2016) 16:248 the necessary levels of physical activity to benefit health in the setting of cardiovascular disease [1, 7, 8]. Increasing physical activity level can improve cardiovascular risk factors, quality of life and exercise capacity in older patients with CAD [11]. It has been suggested that intensity of physical activity is associated with reduced cardiovascular morbidity and mortality in older patients [12]

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Discussion

Conclusion