Promotion and maintenance of physically active lifestyle in older outpatients 2 years after acute coronary syndrome

Gianni Mazzoni; Andrea Raisi; Jonathan Myers; Ross Arena; Leonard Kaminsky; Valentina Zerbini; Rosario Lordi; Giorgio Chiaranda; Simona Mandini; Gianluigi Sella; Elisabetta Tonet; Gianluca Campo; Giovanni Grazzi

doi:10.1007/s40520-021-02044-1

Promotion and maintenance of physically active lifestyle in older outpatients 2 years after acute coronary syndrome

Aging Clin Exp Res. 2022 May;34(5):1065-1072. doi: 10.1007/s40520-021-02044-1. Epub 2022 Jan 8.

Authors

Gianni Mazzoni^{1

2}, Andrea Raisi³, Jonathan Myers^{4

5

6}, Ross Arena^{6

7}, Leonard Kaminsky^{6

8}, Valentina Zerbini¹, Rosario Lordi^{1

2}, Giorgio Chiaranda^{9

10}, Simona Mandini¹, Gianluigi Sella¹¹, Elisabetta Tonet¹², Gianluca Campo¹², Giovanni Grazzi^{1

2

6}

Affiliations

¹ Center for Exercise Science and Sport, University of Ferrara, via Gramicia 35, 44121, Ferrara, Italy.
² Public Health Department, AUSL Ferrara, Ferrara, Italy.
³ Center for Exercise Science and Sport, University of Ferrara, via Gramicia 35, 44121, Ferrara, Italy. andrea.raisi@unife.it.
⁴ Division of Cardiology, VA Palo Alto, Palo Alto, CA, USA.
⁵ Stanford University School of Medicine, Stanford, CA, USA.
⁶ Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA.
⁷ Department of Physical Therapy, University of Illinois at Chicago, Chicago, IL, USA.
⁸ Clinical Exercise Physiology Laboratory, Ball State University, Muncie, IN, USA.
⁹ Public Health Department, AUSL Piacenza, Piacenza, Italy.
¹⁰ General Directorship for Public Health and Integration Policy, Emilia-Romagna Region, Bologna, Italy.
¹¹ Sports Medicine Center, AUSL Ravenna, Ravenna, Italy.
¹² Cardiology Unit, Azienda Ospedaliera Universitaria di Ferrara, Ferrara, Italy.

PMID: 34997543
DOI: 10.1007/s40520-021-02044-1

Abstract

Aims: To examine long-term changes in lifestyle and exercise capacity of older patients hospitalized for acute coronary syndrome (ACS) involved in an innovative centre- and home-based exercise-based secondary prevention program.

Methods: A sample of 118 patients with ACS (age 76 [72-80] years) was analysed. Long-term changes in self-reported weekly leisure-time physical activity (wLTPA), walking speed (WS), and estimated cardiorespiratory fitness (eCRF, VO₂peak, mL/kg/min) were the outcome variables. The program consisted of seven individual on-site sessions including motivational interviewing to reach exercise goals. Exercise prescription was based on the results of a standardized moderate and perceptually regulated treadmill walk to estimate VO₂peak. wLTPA, WS, and eCRF were assessed at 1 (baseline), 2, 3, 4, 6, 12, and 24 months after discharge.

Results: 87, 76, and 70 patients completed follow-up at 6, 12, and 24 months, respectively. wLTPA significantly increased during the follow-up period (median METs/H/week 2.5, 11.2, 12.0, and 13.4 at baseline, 6, 12, and 24 months, respectively; P < 0.0001). At baseline, 18% of the sample met the current international guidelines for physical activity, while 75%, 70%, and 76% of them met the recommended values at 6-, 12-, and 24-month follow-up sessions, respectively. These results were associated with increasing median WS (2.9 ± 1.0, 4.3 ± 1.2, 4.5 ± 1.1, 4.5 ± 1.2 km/h, respectively, P < 0.0001), and VO₂peak (16.5, 21.4, 21.1, 21.3 mL/kg/min, respectively, P < 0.0001).

Conclusions: This early, individualized exercise intervention improved long-term adherence to a physically active lifestyle, walking capacity, and eCRF in older patients after ACS. Larger studies are needed to confirm short- and long-term clinical benefits of this intervention.

Keywords: Acute coronary syndrome; Cardiorespiratory fitness; Cardiovascular diseases; Exercise; Short physical performance battery; Walking speed.

MeSH terms

Acute Coronary Syndrome* / therapy
Aged
Cardiorespiratory Fitness*
Exercise Test / methods
Exercise Therapy
Humans
Life Style
Outpatients