Determinants of physical activity after hospitalization for coronary artery disease: the Tracking Exercise After Cardiac Hospitalization (TEACH) Study.
BACKGROUND
Little is known about physical activity levels in patients with coronary artery disease (CAD) who are not engaged in cardiac rehabilitation. We explored the trajectory of physical activity after hospitalization for CAD, and examined the effects of demographic, medical, and activity-related factors on the trajectory.


METHODS
A prospective cohort study.


METHODS
A total of 782 patients were recruited during CAD-related hospitalization. Leisure-time activity energy expenditure (AEE) was measured 2, 6 and 12 months later. Sex, age, education, reason for hospitalization, congestive heart failure (CHF), diabetes, and physical activity before hospitalization were assessed at recruitment. Participation in cardiac rehabilitation was measured at follow-up.


RESULTS
AEE was 1948+/-1450, 1676+/-1290, and 1637+/-1486 kcal/week at 2, 6 and 12 months, respectively. There was a negative effect of time from 2 months post-hospitalization on physical activity (P<0.001). Interactions were found between age and time (P=0.012) and education and time (P=0.001). Main effects were noted for sex (men more active than women; P<0.001), CHF (those without CHF more active; P<0.01), diabetes (those without diabetes more active; P<0.05), and previous level of physical activity (those active before hospitalization more active after; P<0.001). Coronary artery bypass graft patients were more active than percutaneous coronary intervention (PCI) patients (P=0.033).


CONCLUSIONS
Physical activity levels declined from 2 months after hospitalization. Specific subgroups (e.g. less educated, younger) were at greater risk of decline and other subgroups (e.g. women, and PCI, CHF, and diabetic patients) demonstrated lower physical activity. These groups need tailored interventions.
Reid
Robert D
RD
Prevention and Rehabilitation Centre and Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Canada. breid@ottawaheart.ca
Morrin
Louise I
LI
Pipe
Andrew L
AL
Dafoe
William A
WA
Higginson
Lyall A J
LA
Wielgosz
Andreas T
AT
LeHaye
Stephen A
SA
McDonald
Paul W
PW
Plotnikoff
Ronald C
RC
Courneya
Kerry S
KS
Oldridge
Neil B
NB
Beaton
Louise J
LJ
Papadakis
Sophia
S
Slovinec D'Angelo
Monika E
ME
Tulloch
Heather E
HE
Blanchard
Chris M
CM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003327:Coronary Disease / Q000503:physiopathology* / Q000534:rehabilitation; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D011379:Prognosis; D011446:Prospective Studies