Search
Close
Search
Advanced Search
Search Menu
AI Discovery Assistant

Abstract

Aims

To evaluate the long-term clinical impact of the application of cardiac rehabilitation (CR) early after discharge in a real-world population.

Methods and results

We analysed the 5-year incidence of cardiovascular mortality and hospitalization for cardiovascular causes in two populations, attenders vs. non-attenders to an ambulatory CR program which were consecutively discharged from two tertiary hospitals, after ST-elevation myocardial infarction, non-ST-elevation myocardial infarction, coronary artery bypass graft, or planned percutaneous coronary intervention. A primary analysis using multivariable regression model and a secondary analysis using the propensity score approach were performed. Between 1 January 2009 and 31 December 2010, 839 patients attended a CR program planned at discharged, while 441 patients were discharged from Cardiovascular Department without any program of CR. During follow-up, the incidence of cardiovascular mortality was 6% in both groups (P = 0.62). The composite outcome of hospitalizations for cardiovascular causes and cardiovascular mortality were lower in CR group compared to no-CR group (18% vs. 30%, P < 0.001) and was driven by lower hospitalizations for cardiovascular causes (15 vs. 27%, P < 0.001). At multivariable Cox proportional hazard analysis, CR program was independent predictor of lower occurrence of the composite outcome (hazard ratio 0.58, 95% confidence interval 0.43–0.77; P < 0.001), while in the propensity-matched analysis CR group experienced also a lower total mortality (10% vs. 19%, P = 0.002) and cardiovascular mortality (2% vs. 7%, P = 0.008) compared to no-CR group.

Conclusion

This study showed, in a real-world population, the positive effects of ambulatory CR program in improving clinical outcomes and highlights the importance of a spread use of CR in order to reduce cardiovascular hospitalizations and cardiovascular mortality during a long-term follow-up.

Coronary artery disease, Cardiac rehabilitation, Cardiovascular mortality, Cardiovascular hospitalization, Propensity score
Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2018. For permissions, please email: [email protected].
This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)
Issue Section:
Clinical Research > Coronary artery disease
You do not currently have access to this article.
Download all slides

Comments

2 Comments
Comments (2)
ACAI Center of Cardiac Rehab from La Plata - Argentine
24 February 2019
Alejandro M. Gómez Monroy MD. Specialist in Cardiology
Argentinian Heart Federation (FAC)
I agree completely with Jo Carol Stephens, in my country (Argentina) and Latinameríca is the same problem, one important part of the problem is the Cardiologist, it is guilty because do not prescribing the Cardiac Rehab.
And this should be legally a "medical malpractice"...
Submitted on 24/02/2019 2:41 PM GMT
Former Director Healthy Lifestyle Centers
24 August 2018
[email protected]
kentuckyOneHealth
It continues to amaze me that cardiac rehab remains underutilized. No cardiologist would let a patient leave the hospital without prescribing an aspirin, beta blocker, and anti- platelets therapy however patients are being discharged without discussion from physician about the importance of cardiac rehab. The number one predictor of a patient’s decision to attend cardiac rehab is the physician insisting the patient attend as part of the treatment plan. How much more research is needed to implement best practice
Jo Carol Stephens, MSN , RN , BC
Submitted on 24/08/2018 2:08 PM GMT