Introduction:
Despite the benefits of participation in regular physical activity (PA) following acute myocardial infarction (AMI), little is known about the habitual patterns of PA for young AMI patients, especially expanding beyond findings for those engaged in cardiac rehabilitation. We assessed patterns and determinants in levels of PA over a period of 12-months following AMI.
Methods:
A 2:1 (women:men) observational study design enrolled 3,572 AMI patients (2,397 women, 67.1%) aged 18-55 years from 103 US, 24 Spanish, and 3 Australian hospitals (2008-2012). Data were obtained by medical record abstraction and patient interviews at baseline (pre-AMI), 1- and 12-months post-AMI. Patients were assigned to AHA defined levels of PA based on self-reported frequency, duration, and intensity, as follows:
Active
(≥ 150 min/wk moderate or ≥ 75 min/wk vigorous activity),
Insufficient
(10-149 min/wk moderate or 10-74 min/wk vigorous activity), or
Inactive
(< 10 min/wk moderate or vigorous activity). We used a generalized estimating equation model to examine the factors associated with insufficient/inactive PA levels over time.
Results:
At baseline, 1- and 12-months post-AMI, 36.7%, 37.6%, and 40.0% of patients were considered active. There were 27 PA patterns observed from baseline to 12-months (Table). The most frequent were those with no change in PA over time (14% staying active, 7% insufficient, and 13% inactive). Additionally, 25% of patients had an increase (at least a one category change) in PA, while 19% had a decrease between baseline and 12-months post-AMI. Female sex, non-white race, non-active workplaces, smoking, diabetes, hypertension, and obesity were independently associated with being insufficient/inactive over time (all p<.05).
Conclusions:
Despite clinical recommendations, young adults recovering from AMI experience a wide range of PA patterns. By identifying factors associated with insufficient/inactive PA during recovery, targeted interventions can be introduced prior to hospital discharge.
Decade-Long Trends and Factors Associated With Time to Hospital Presentation in Patients With Acute Myocardial Infarction
