Prognostic Impact of Physical activity patterns after percutaneous coronary intervention - PIPAP study

Physical activity monitoring after coronary bypass grafting and other major surgeries has been found to be predictive for hospital readmission and adverse outcome. In patients after percutaneous coronary intervention (PCI) it has been found that a patient reported activity score is predictive of 3 year major adverse coronary event (MACE).It is not known whether physical activity shortly after discharge from percutaneous coronary intervention is predictive of one-year MACE. Early identification of patients at increased risk of MACE would facilitate the intensification of preventive strategies in these patients.

The aim of this study is to determine whether number of daily steps following hospital discharge can serve as a risk predictor for MACE in patients after PCI. We will include patients after PCI younger than 80 years of age who are eligible for ambulatory CR. Exclusion criteria are inability to participate in ambulatory CR (nursing home residence, stationary CR, orthopedic or neurologic impairment prohibiting physical exercise, psychiatric conditions). Primary objective is the quantification of physical activity (daily steps) during the first two weeks after hospital discharge as a predictor for MACE at one year. MACE, patient characteristics, patient history, risk factors and comorbidities will be extracted from CARDIOBASE Bern PCI registry. Secondary objectives are: 1) Phenotyping of physically active versus inactive patients; 2) Association of daily steps after discharge and at one year; 3) Comparison between daily steps and objectively measured activity counts (divided in time spent in moderate-to-vigorous activity, light activity and sedentary activity), as well as patient reported activity; 4) Association of daily steps after one year with reaching targets for systolic blood pressure, low-density lipoprotein cholesterol (LDL-C), body mass index (BMI) and glycated haemoglobin (HbA1c); 5) comparison of daily steps after hospital discharge in groups of no cardiac rehabilitation (CR) uptake, versus conventional hospital based CR, tele-CR and modular CR; 6) comparison of daily steps at one year after hospital discharge in different CR groups.

Recruitment of approximately 800 patients is planned to start in Oct 2020 and will last until April 2022. Last follow-up will be in April 2023.