March 3, 2026

Exercise-based secondary prevention program impacts physical activity behavior and cardiorespiratory fitness in older outpatients after acute coronary syndrome

Key Result

Exercise-based secondary prevention increased weekly physical activity from 2.5 to 13.4 METs/h, walking speed from 2.9 to 4.5 km/h, and VO2peak from 16.5 to 21.3 mL/kg/min over 24 months in older ACS

Key Points

Increased walking speed and cardiorespiratory fitness were observed after the exercise intervention in older patients.
At 24 months, the median weekly leisure-time physical activity increased significantly to 13.4 METs/h/week.
Assessment included a treadmill walk test to estimate cardiorespiratory fitness levels before and after the intervention.
The findings support the need for tailored exercise programs for older patients post-acute coronary syndrome.

Structured PICO

Does a center- and home-based exercise secondary prevention program improve physical activity behavior and cardiorespiratory fitness in older outpatients after acute coronary syndrome?

Population

118 older outpatients after acute coronary syndrome (ACS), mean age 76 years.

Intervention

Center- and home-based secondary prevention program consisting of 7 individual on-site sessions including motivational interviewing and exercise prescription based on a treadmill walk test.

Outcome

Long-term changes in self-reported weekly leisure-time physical activity (wLTPA), walking speed (WS), and estimated cardiorespiratory fitness (eCRF, VO2peak) at 6, 12, and 24 months.surrogate

An early, individualized center- and home-based exercise program significantly improves long-term physical activity adherence and cardiorespiratory fitness in older patients following acute coronary syndrome.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Background: Older cardiac patients show the highest risk of sedentary behavior and mobility limitation. Despite benefits of physical activity are well-recognized in secondary prevention programs, patients with acute coronary syndrome (ACS) are less likely to attend traditional center-based interventions. Objectives: To examine long-term changes in behavior and exercise capacity of patients with ACS involved in a center- and home-based secondary prevention program. Methods: A total of 118 patients (mean age 76 years) was analyzed. Main outcomes were long-term changes in self-reported weekly leisure-time physical activity (wLTPA), walking speed (WS) and estimated cardiorespiratory fitness (eCRF, VO2peak). Intervention program consisted of 7 individual on-site sessions including motivational interviewing to reach exercise goals. Exercise prescription was based on the results of a treadmill walk test to estimate VO2peak. Functional variables were assessed during each visit after discharge. Results: Follow-up at 6-, 12-, and 24-months, was completed by 87, 76, and 70 patients 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). 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. Results may provide valuable insights for the development of exercise-based secondary prevention programs.

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