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Updated: Aug 30, 2025
A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program
Published on: April 19, 2019
Correlation of Walking Activity and Cardiac Hospitalizations in Coronary Patients for 1 Year Post Cardiac
Sinann Al Najem1,2, Andreas Groll3, Axel Schmermund4,5
1German Heart Foundation, Frankfurt, Germany.
Insights
Increasing daily steps after cardiac rehabilitation significantly lowers hospitalization risk for coronary patients. Monitoring daily steps can help predict patient outcomes and guide recovery strategies.
Area of Science:
- Cardiology
- Preventive Medicine
- Rehabilitation Science
Background:
- Cardiac rehabilitation (CR) aims to reduce cardiovascular risk through improved fitness.
- Assessing post-CR patient prognosis is crucial for effective long-term management.
- The impact of daily physical activity, specifically step count, on cardiac patient outcomes requires further investigation.
Purpose of the Study:
- To determine the correlation between daily steps post-CR and the prognosis of coronary patients.
- To analyze the association of step count with cardiac hospitalizations, mortality, and symptoms.
- To explore the influence of ejection fraction (EF), gender, and age on these outcomes.
Main Methods:
- One hundred eleven patients (91 male, 20 female; mean age 61±11 years) post-CR were enrolled.
- Patients self-documented daily steps, blood pressure, weekly weight, and cardiac events for one year.
- Cox proportional hazard models and Kaplan-Meier curves analyzed the impact of steps/day, EF, gender, and age.
Main Results:
- Average daily steps post-CR were 7333 (SD 4426).
- Higher daily step counts were associated with reduced cardiac hospitalization risk (e.g., 5000 vs 7500 steps/day showed a 0.43 HR reduction).
- Patients with lower ejection fraction (EF < 55%) faced a significantly higher risk of adverse events (HR increase of 2.88).
Conclusions:
- Monitoring daily step count in patients post-CR is a valuable tool for prognosis assessment.
- Encouraging increased physical activity, measured in steps, can mitigate hospitalization risks in cardiac patients.
- Ejection fraction is a significant predictor of outcomes, highlighting the need for personalized CR strategies.
Problem:
Reducing risk by improving fitness is one of the main objectives of cardiac rehabilitation (CR). To estimate how the number of steps/day post-CR affects coronary patients' prognosis, we analyzed its correlation with the occurrence of death, hospitalizations, and heart complaints, and if and how other variables (ejection fraction (EF), gender, age) relate to those.
Methods:
One hundred eleven patients (male = 91, female = 20; average age ± standard deviation (SD): 61 ± 11 years) who had been in CR due to recent coronary revascularization or chronic coronary syndrome could be enrolled. Patients were advised to document their steps (daily), blood pressure (daily), weight (weekly) and occurrences of a cardiac event in a diary for 1 year post-CR. A Cox proportional hazard model was used to examine the influence of steps/day, EF, gender, and age until the occurrence of an event. Kaplan-Meier curves were generated to compare patients' profiles.
Results:
Average steps/day of patients post-CR were 7333 (SD 4426). Increased walking activity reduced risk for cardiac hospitalization (constant steps/day: 5000 vs 7500, hazard rate (HR) reduction of 0.43; 10 000 vs 12 500, HR reduction of 0.20) and risk was higher in patients with an EF < 55% versus EF ⩾ 55% (HR increase of 2.88). Median follow-up time post-CR was 218 days. No patient died, 25 were hospitalized.
Discussion:
Monitoring the number of steps of coronary patients post CR could be valuable for estimating patients' prognosis.
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