Compliance to a Cardiac Rehabilitation Program: what are the benefits and impact on prognosis?

• Type: Summary of Presentation in an International Conference
• Date: 2012

Authors

Rangel I (Author) Other; Rocha A (Author) Other; Sousa C (Author) Other; Sousa A (Author) Other; Correia AS (Author) Other; Paiva M (Author) Other; Melão F (Author) Other; Ribeiro V (Author) Other; Oliveira S (Author) Other; Lebreiro A (Author) Other; Araújo V (Author) Other; Parada F (Author) Other; Maciel MJ (Author) FMUP

Conference proceedings International

Title: European Journal of Heart Failure Supplements

Initial page: P1149

Heart Failure Congress 2012

Belgrade, 2012

Scientific classification

FOS: Medical and Health sciences > Clinical medicine

Other information

Abstract (EN): Background: Cardiac rehabilitation programs (CRP) have consistently demonstrated the ability to improve cardiac risk factors and reduce morbi-mortality. Objective: To assess the clinical benefits and CRP compliance impact on prognosis, in a coronary heart disease population. Methods: We evaluated a total of 241 patients referenced to a CRP after an acute coronary syndrome (ACS), recruited between September 2008 and November 2010. Information on socio-demographic, clinical and functional data was collected pre and post CRP. Functional capacity was assessed in metabolic equivalents (METS), determined by exercise stress testing. Telephonic interview to patients with at least 12 months of follow-up after index event was performed to assess the occurrence of composite endpoint of overall mortality and nonfatal cardiovascular events. Results: Study population consisted of 241 patients, mostly male (89%), aged 54±10 years (range 28-80). Non compliance was found in 24 (10%) patients and it was more common in women than men (23% versus [vs] 8%; p=0.030) and in obese patients (18% vs 8%; p=0.024). No significant differences were found in other baseline characteristics, including ACS type and severity indicators. At 6 to 12 months post index event, health status comparison between the 2 groups demonstrated that compliers achieved better control of cardiovascular risk profile: higher smoking cessation rate (70% vs 18%, p=0.001) and higher rates of adequate physical activity [82% vs 25%, p=0.022]. A significant improvement was found, only in the compliant group (CG), regarding functional capacity (+0.8 (1.6) METS, p<0.001 vs -0.6 (0.9) METS, p=0.208) and lipid profile (LDL-cholesterol [LDL-C]: -39.1 [39.6], p<0.001; HDL-C: +3.2 [8.7], p <0.001 and triglycerides [Tg]: -38.7 [102.7], p<0.001 vs LDL-C: -9.6 [37.1], p=0.434; HDL-C: +3.6 [6.4], p=0.096 and Tg: -10.8 [58.6], p=0.554). Follow-up data was available in 227 (94%) patients, with a mean follow-up time of 25 ± 7 months. Composite endpoints were found in 23 (10%) patients and tended to be more frequent in non-CG (17% vs 9%; p=0.182). With Cox regression analysis, non-compliance behavior was associated with a higher likelihood of composite endpoint occurrence, although no statistical significance was achieved (HR: 2.2, 95% CI: 0.7-6.4). Conclusion: CRP compliant patients have a significant higher improvement in cardiovascular risk profile, functional capacity and tend to suffer less cardiovascular events than non compliant patients. Specific strategies are needed, in order to prevent drop-out and maximize the benefit of CRP.

Language: English

Type (Professor's evaluation): Scientific

Notes: Rangel I, Rocha A, Sousa C, Sousa A, Correia AS, Paiva M, Melão F, Ribeiro V, Oliveira S, Lebreiro A, Araújo V, Parada F, Maciel MJ. Compliance to a Cardiac Rehabilitation Program: what are the benefits and impact on prognosis? Eur J Heart Fail Suppl 2012; 11(Suppl 1): P1149. ISSN 1567-4215. Heart Failure Congress 2012, Belgrade, 2012