Lower cardiac rehabilitation enrolment occurs in acute coronary syndrome patients who report low levels of physical activity at four weeks post-event: A prospective observational study using physical activity tracker data

Background: Physical activity (PA) and cardiac rehabilitation (CR) attendance are important for recovery and prognosis following acute coronary syndrome (ACS). However, PA patterns early post -ACS are not well known. Objectives: Investigate the level of PA at 4 -weeks post -ACS and any potential associations with CR enrolment. Methods: We recruited patients admitted for ACS from cardiac wards and clinics at two hospital sites in Sydney, Australia. PA data were collected using wearable activity trackers worn at 4 -weeks post -ACS, and CR enrolment was self -reported. Results: Participants (n = 61) were aged 66.7 +/- 10.3 years, 74 % male, 61 % were married or partnered, and 33 % were diagnosed with ST -elevation myocardial infarction. Patients engaged in 7514 +/- 3355 steps per day and 44.6 +/- 37.5 min of moderate -to -vigorous physical activity (MVPA). Patients who enrolled in CR exhibited higher daily step counts (p = 0.044), MVPA minutes (p = 0.001), and were more likely to meet PA guidelines. ACS patients who engaged in higher levels of MVPA were more likely to enrol in CR (odds ratio [OR] 1.46; 95 % confidence interval [CI] 1.08, 1.98). CR enrolment was also positively associated with being married or in an intimate partnership (OR 9.93; 95 % CI 1.83, 53.85) and absence of depressive symptoms (OR 11.86; 95 % CI 1.91, 73.74). Conclusion: Lower CR enrolment rates were observed among less physically active patients at 4 -weeks post -ACS. However, each 10 min increment in MVPA increased the odds of CR enrolment by 46 %. Future research should explore strategies to target this inactive and high -risk group, given the potential for a large prognostic gain with CR participation.