Sedentary Behavior and Risk of Readmission After Hosptialization for Suspected Acute Coronary Syndrome: A Prospective Study

BACKGROUND: To examine the prospective association between device-measured sedentary behavior and risk of emergency department (ED) or hospital readmission among patients with suspected acute coronary syndrome (ACS), independent of moderate to vigorous physical activity (MVPA). METHODS: 536 patients who were evaluated for suspected ACS were enrolled between September 2016 and March 2020. Sedentary behavior and MVPA were measured via wrist-worn GENEActiv accelerometer for 30-days post-discharge. ED and hospital readmissions between 30 and 365 days after discharge were ascertained by chart review and patient contact. RESULTS: Over 1-year follow-up, 198 patients were readmitted. Sedentary behavior was associated with an increased risk of ED or hospital readmission after adjusting for covariates and MVPA [Tertile 1: REF, Tertile 2: HR = 0.89 (95% CI: 0.60–1.32), Tertile 3: HR = 1.73 (95% CI: 1.16–2.58), P-trend = 0.003]. In joint association analyses, high sedentary behavior in combination with low MVPA was associated with the greatest risk of ED or hospital readmission [HR = 2.36 (95%: CI: 1.52–3.68)] compared to the referent group (low sedentary behavior/high moderate to vigorous physical activity). CONCLUSIONS: Sedentary behavior was associated with an increased risk of ED or hospital readmission between 30 and 365 days after discharge among patients with suspected ACS, independent of MVPA. These findings suggest reducing sedentary behavior should be considered as a modifiable therapeutic target to reduce subsequent ED or hospital readmission in patients following a suspected ACS.