# Impact of Prolonged Sedentary Behavior on Cardiac Outcomes and Mortality in Acute Coronary Syndrome Patients

> **NIH NIH R01** · COLUMBIA UNIVERSITY HEALTH SCIENCES · 2020 · $513,036

## Abstract

The purpose of this ancillary project is to evaluate prolonged sedentary behavior as a potential therapeutic
target for intervention after an acute coronary syndrome (ACS). More than 1.1 million patients are hospitalized
annually for ACS in the United States alone. With the advent of new technologies and medications, most
patients hospitalized with an ACS survive, however they remain at high risk for recurrent cardiac events and
mortality; underscoring a critical need to identify prognostic risk factors that can be targeted for intervention.
One such risk factor may be sedentary behavior. Evidence suggests that sedentariness is a “toxic” health
behavior (and not merely the absence of physical activity), conferring pathophysiological changes that greatly
contribute to morbidity/mortality risk. ACS patients are particularly prone to high volumes of sedentariness after
hospitalization; accruing, on average, 12-13 hours/day, with many exceeding 15 hours daily. This raises the
question as to whether reducing sedentary behavior may represent another therapeutic target for secondary
prevention of ACS patients independent from, and in addition to, physical activity. No existing guidelines for
secondary prevention in ACS patients, however, mention sedentary behavior as a risk factor to be treated. This
omission may be due to a lack of empirical evidence, as no study to date has assessed whether objectively-
measured sedentary behavior incurs increased morbidity/mortality risk post-ACS, independent of cardiac
disease severity and physical activity. The NHLBI-funded ‘Post-Hospital Syndrome’ (PHS) study provides a
unique opportunity to evaluate sedentary behavior as a prognostic risk factor among ACS survivors. This study
comprises a cohort of 1,000 ACS patients who present to the emergency room and are followed throughout
their hospital stay to determine whether in-hospital stress, sleep, physical activity, and/or weight loss are
associated with 30-day rehospitalization. In this ancillary study, we propose to additionally measure sedentary
behavior objectively for 30 days post-discharge among 862 PHS study patients using triaxial accelerometers
that can distinguish both posture and movement. We will also ascertain ACS recurrence and mortality at 1-year
follow-up. Finally, we will assess biomarkers of inflammation, procoagulant activity, and dyslipidemia in-
hospital and at 1-month follow-up. These data will be used to primarily evaluate whether objectively-measured
sedentary behavior is associated with risk of 1-year recurrent events/mortality among post-ACS patients.
These data will also be used to inform future interventions to reduce sedentary behavior among ACS survivors
by (1) determining the type of activity (standing or walking) that sedentary-reduction strategies should be
targeting, and (2) identifying an intermediary target (e.g. inflammation, procoagulant activity, dyslipidemia) to
assess intervention efficacy. The results of this study could hav...

## Key facts

- **NIH application ID:** 9840926
- **Project number:** 5R01HL134985-04
- **Recipient organization:** COLUMBIA UNIVERSITY HEALTH SCIENCES
- **Principal Investigator:** Keith M Diaz
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $513,036
- **Award type:** 5
- **Project period:** 2017-01-01 → 2022-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9840926

## Citation

> US National Institutes of Health, RePORTER application 9840926, Impact of Prolonged Sedentary Behavior on Cardiac Outcomes and Mortality in Acute Coronary Syndrome Patients (5R01HL134985-04). Retrieved via AI Analytics 2026-05-21 from https://api.ai-analytics.org/grant/nih/9840926. Licensed CC0.

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