Key takeaways  

  • A prospective cohort study investigated whether physical activity early after a myocardial infarction (MI) is associated with cardiovascular events.  
  • High levels of post-discharge physical activity after an MI were not associated with an increase in short-term or long-term cardiovascular events compared with low levels, supporting early mobilisation.  
  • High levels of pre-admission physical activity were associated with improved 5-year event-free survival, highlighting the long-term protective effects of an active lifestyle. 

Ljubljana, Slovenia – 23 April 2026: Early physical activity after a myocardial infarction was not associated with increased cardiovascular events, according to a presentation today at ESC Preventive Cardiology 2026,[1] the annual congress of the European Association of Preventive Cardiology (EAPC), a branch of the European Society of Cardiology (ESC). 

Physical activity is essential to prevent disease progression in patients after a myocardial infarction (MI). Participation in an exercise-based cardiac rehabilitation programme is recommended [2,3] and typically starts several weeks after an MI. Physical activity is generally restricted in the first week post-discharge, largely due to safety concerns that are not based on evidence. 

“Early mobilisation after MI is increasingly common as hospital stays shorten, leading to an increase in physical activity as patients return to their home environment, and yet data on the safety of early physical activity are scarce,” explained Rik Dijkman from Radboud University Medical Centre, Nijmegen, Netherlands. He continued, “We investigated the long-term prognostic value of levels of post-discharge physical activity, and also pre-admission physical activity, in relation to major cardiovascular events.” 

This prospective cohort study included consecutively admitted patients who were hospitalised for MI at the Radboud University Medical Centre. Participants were provided with a thigh-worn accelerometer to measure their physical activity levels during the first week post-discharge. Patients were classified into a high or low post-discharge physical activity group based on the median value. Pre-admission physical activity was assessed retrospectively with a validated questionnaire. The primary outcome was the incidence of major adverse cardiovascular events (MACE; all-cause mortality, another MI, unplanned coronary revascularisation, acute heart failure and stroke) at 1, 3 and 6 months. A secondary outcome was MACE over five years related to pre-admission and post-discharge physical activity levels. 

The analysis population comprised 165 patients who had a mean age of 65 years and 35% were female.  

Higher levels of post-discharge physical activity were not associated with an increased risk of MACE at 1, 3 or 6 months in patients after an MI. At six months, MACE occurred in 8.5% of patients in the high post-discharge physical activity group and 8.4% in the low physical activity group. 

Over five years, there was no significant difference in MACE between patients with high vs. low post-discharge physical activity (adjusted hazard ratio [HR] 1.85; 95% confidence interval [CI] 0.96 to 3.57; log-rank p=0.33). 

In contrast, patients with high levels of pre-admission physical activity had fewer events and significantly longer MACE-free survival over five years than those with low pre-admission levels (adjusted HR 0.47; 95% CI 0.25 to 0.86; log-rank p=0.03). 

No correlation was observed between pre-admission and post-discharge physical activity levels, indicating that those with high pre-admission levels did not automatically return to such levels post-discharge. 

Summing up the results, Mr Dijkman concluded: “Reassuringly, our findings suggest that being physically active after discharge was not associated with an increased risk of cardiovascular events. The period after an MI can act as a ‘teachable moment’ as patients may be more receptive to reconsidering lifestyle behaviour and it seems that encouraging early activity at this time is safe. The longer MACE-free survival in those who were physically active pre-admission highlights long-term protective effects and further supports promoting an active lifestyle.” 

ENDS