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.

Cardiovascular diseases remain the leading cause of death in the Western world despite advances in therapeutics and interventions. The prescription of physical activity is a key component of cardiac rehabilitation following myocardial infarction. This review aims to outline the impact of physical activity in particular patient cohorts with coronary artery disease. The current understanding of the mechanisms involved in atherosclerosis, plaque rupture and thrombosis, and how these can be modified by physical activity, are also discussed. There is the potential for future research to investigate the clinical and mechanistic effects of different exercise types, intensities, duration, and frequencies in patients hospitalized for coronary artery disease.

Introduction: A wide variety of exercise regimes produce significant reductions in coronary artery disease (CAD) risk and modulate the pathogenesis of CAD. Given the ongoing burden of cardiovascular disease and an aging population, physical activity (PA) in patients with CAD needs to be emphasized in addition to the use of advanced therapeutic and pharmacological interventions in their management. It is not known whether PA levels differ among older patients following percutaneous coronary intervention (PCI) for stable angina (SA) vs. acute coronary syndrome (ACS) consisting of ST-segment elevation myocardial infarction (STEMI) and non STEMI (NSTEMI). Hypothesis: To determine differences in the distribution of time spent in acceleration categories reflecting sedentary behaviour and PA in older patients (≥75 years) following PCI. Methods: We evaluated sedentary behaviour and PA amongst patients following PCI for SA (n=20), STEMI (n=20) and NSTEMI (n=18) upon discharge from a tertiary centre over a 7-day period using wrist-worn triaxial accelerometers (GENEActiv, Activinsights Ltd, United Kingdom). Results: Mean ± Standard deviation age was 79±4 years (31% female). STEMI and NSTEMI patients spent more time in the lowest acceleration category (0-40mg) than SA patients (1298±59 and 1305±66 vs. 1240±92 minutes/day, p<0.05). STEMI and NSTEMI patients spent less time than SA patients in the 40-80mg acceleration category (95±35 and 94±41 vs. 132±50 minutes/day, p<0.05). These trends continued for acceleration categories 80-120mg (p<0.05) and 120-160mg (p<0.05) but only between SA and NSTEMI patients. SA patients spent more time than NSTEMI patients in the 1 (15±18 vs. 6±9 minutes/day, p<0.05) and 5 (6±10 and 1±3 minutes/day, p<0.05) minute moderate-vigorous intensity PA bouts (≥100mg category). For the higher acceleration categories (≥160 mg), no differences between the groups were observed. Conclusions: Patients presenting with ACS and undergoing PCI spent more time in the low acceleration category reflecting sedentary behaviour and sleep compared with SA patients. Following PCI for ACS, strategies may need to be put in place to ensure that ACS patients achieve the mid category acceleration.