Twenty-Year Trajectories of Physical Activity and Acute Coronary Syndrome Incidence; the GREECS Epidemiological Study (2004-2024).

The aim of the present study is to investigate the association between 20-year trajectories of physical activity status and cardiovascular disease (CVD) incidence, among Acute Coronary Syndrome (ACS) patients. GREECS study is a multi-centered prospective study. Almost all (n = 2172; mean age 62 ± 11 years; 1649 (76%) males) consecutive patients who were hospitalized in the cardiology clinics or the emergency cardiology departments were entered in the study. Four physical activity trajectories were formed regarding the 20-year tracking (from 2004 to 2024), of their physical activity levels (i.e., always inactive or active, turned from inactive/active). Of the 1913 ACS patients who participated in the 20-year follow-up, 51% were consistently inactive, 31% changed from physically active to inactive, 11% from inactive to active, and 7% were consistently active. During the 20-year follow-up 67% of ACS patients experienced a new CVD event. Consistently active patients had 45% lower risk for a recurrent CVD event during the 20-year follow-up period (95% CI, 12% to 64%), as compared to consistently inactive. Sustained engagement in physical activity is associated with a reduced risk of recurrent CVD events among ACS patients. These findings underscore the importance of promoting and sustaining physical activity as a key component of tertiary CVD prevention.