Department of Nursing, Wonkwang University, Iksan, South Korea.
College of Nursing, Dongguk University, Gyeongju, South Korea.
Medicine (Baltimore). 2023 Nov 10;102(45):e35839. doi: 10.1097/MD.0000000000035839.
Sedentary behavior has been associated with poor adherence to treatment in patients with coronary artery disease. Low left ventricular ejection fraction and obesity have been separately linked to increased sedentary behavior in patients with coronary artery disease. However, the combined effect of low left ventricular ejection fraction and obesity on sedentary behavior in patients with coronary artery disease has not been thoroughly investigated. Therefore, this study aimed to examine the combined influence of left ventricular ejection fraction and obesity on sedentary behavior in patients with coronary artery disease. This descriptive cross-sectional study enrolled 200 inpatients aged ≥ 20 years who were diagnosed with coronary artery disease at a tertiary hospital in Korea between March and August 2022. Data were collected using structured questionnaires, and multivariate logistic regression analysis was performed to determine the combined effect of left ventricular ejection fraction and obesity on sedentary behavior in patients with coronary artery disease. Among the 111 patients with sedentary behavior, 38 (34.2%) had both low left ventricular ejection fraction and obesity, whereas only 11 (12.4%) of the 89 patients without sedentary behavior had both low left ventricular ejection fraction and obesity. In multivariate logistic regression analysis, patients with coronary artery disease who had both low left ventricular ejection fraction and obesity had the highest risk of sedentary behavior compared to those without either low left ventricular ejection fraction or obesity (odds ratio = 13.98, 95% confidence interval = 5.19-37.69, P < .001). The co-existence of low left ventricular ejection fraction and obesity in patients with coronary artery disease may be associated with sedentary behavior. Therefore, evaluating both left ventricular ejection fraction and obesity when assessing sedentary behavior in patients with coronary artery disease may be valuable in implementing patient-centered approaches for the secondary prevention and management of sedentary behavior in patients with coronary artery disease. However, further prospective cohort studies with larger sample sizes are required to establish causal relationships and explore interventions to mitigate sedentary behavior in this population.
久坐行为与冠心病患者治疗依从性差有关。左心室射血分数降低和肥胖分别与冠心病患者久坐行为增加有关。然而，左心室射血分数降低和肥胖对冠心病患者久坐行为的综合影响尚未得到充分研究。因此，本研究旨在探讨左心室射血分数和肥胖对冠心病患者久坐行为的综合影响。本描述性横断面研究纳入了 200 名在韩国一家三级医院诊断为冠心病的≥20 岁住院患者，研究时间为 2022 年 3 月至 8 月。使用结构化问卷收集数据，并进行多变量逻辑回归分析，以确定左心室射血分数和肥胖对冠心病患者久坐行为的综合影响。在 111 名有久坐行为的患者中，38 名（34.2%）同时存在左心室射血分数降低和肥胖，而在 89 名无久坐行为的患者中，仅有 11 名（12.4%）同时存在左心室射血分数降低和肥胖。多变量逻辑回归分析显示，与既没有左心室射血分数降低也没有肥胖的冠心病患者相比，同时存在左心室射血分数降低和肥胖的冠心病患者有久坐行为的风险最高（比值比=13.98，95%置信区间=5.19-37.69，P<0.001）。冠心病患者同时存在左心室射血分数降低和肥胖可能与久坐行为有关。因此，在评估冠心病患者的久坐行为时，评估左心室射血分数和肥胖可能有助于实施以患者为中心的方法，以预防和管理冠心病患者的久坐行为。然而，需要进一步开展具有更大样本量的前瞻性队列研究，以确定因果关系，并探索干预措施来减轻该人群的久坐行为。
