Trajectory of Physical Activity Changes and its Influencing Factors in Chinese Patients With Coronary Heart Disease Post-PCI

BACKGROUND: Coronary heart disease (CHD) is a leading cause of death worldwide. While percutaneous coronary intervention (PCI) improves myocardial perfusion, it does not stop disease progression, making physical activity essential yet often suboptimal and poorly characterized after PCI. OBJECTIVE: This study aimed to identify the trajectories and latent categories of physical activity among patients with CHD over a 9-month period after PCI and to determine the factors associated with these distinct trajectory categories. METHODS: A longitudinal observational study was conducted with 447 patients with CHD undergoing PCI at a Beijing cardiovascular hospital (November 2022-April 2023). Their physical activity was assessed using the International Physical Activity Questionnaire-short form at baseline and 3, 6, and 9 months post-PCI. RESULTS: Latent class growth modeling identified 3 distinct physical activity trajectory categories within 9 months post-PCI: "Decline Trajectory" (50.3%), "Stable Trajectory" (21.2%), and "Increase Trajectory" (28.5%). Multinomial logistic regression analysis revealed that compared with the "Stable Trajectory" group, the "Decline Trajectory"group was significantly associated with prior PCI history, implantation of >3 stents, low perceived behavioral advantages, and high perceived behavioral disadvantages. The "Increase Trajectory" group was associated with high behavioral self-confidence, high maintenance intention, and low illness perception. CONCLUSIONS: This study identified 3 distinct physical activity trajectories in patients with CHD after PCI and revealed key influencing factors for each trajectory. These findings provide an evidence base for developing tailored postoperative rehabilitation strategies, potentially improving both physical activity levels and long-term clinical outcomes in this patient population.