BackgroundThere are no diagnosis-specific guidelines for moderate-to-vigorous physical activity (MVPA) and sedentary behaviour (SB) for coronary heart disease (CHD). This study aims identifying thresholds of MVPA and SB associated with cardiovascular events. MethodsCohort study including individuals with CHD. MVPA and SB were self-reported, and health registers identified cardiovascular events (2006-2022). Survival tree analyses identified thresholds of time associated with the risk of cardiovascular events. Thresholds were explored in Cox regression models. ResultsThere were 40,156 Australians, 62% men, mean age 70 years. Over 8.3 median years, 3260 non-fatal cardiac events, 5161 total cardiac events, and 14,383 major adverse cardiovascular events (MACE) occurred. Thresholds for MVPA were 122 minutes/week for non-fatal cardiac events and 94 minutes/week for total cardiac events and MACE. Meeting MVPA thresholds was associated with an 18% lower risk for non-fatal cardiac events, 29% lower risk of total cardiac events, and 23% lower risk of MACE than not reaching the thresholds. Thresholds for SB were 4 and 10 hours/day respectively for risk of total cardiac events and MACE. SB below thresholds was associated with a 14% lower risk of total cardiac events and an 18% lower risk of MACE. There were sex-specific thresholds for MVPA and SB. ConclusionTo lower cardiovascular event risk, identified MVPA thresholds were lower (94-122 minutes/week) than the public health guidelines (150 minutes/week) in individuals with CHD. The SB thresholds associated with a lower risk of total cardiac events and MACE varied between 4-10 hours/day.
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