Francesco Giallauria1, Francesco Fattirolli2, Roberto Tramarin3, Marco Ambrosetti4, Raffaele Griffo5, Carmine Riccio6, Stefania De Feo7, Massimo Francesco Piepoli8, Carlo Vigorito9. 1. Department of Translational Medical Sciences, Division of Internal Medicine and Cardiac Rehabilitation, University of Naples "Federico II", Naples, Italy. Electronic address: giallauria@libero.it. 2. Department of Critical Care Medicine and Surgery, Cardiac Rehabilitation Unit, University of Florence and Azienda Ospedaliero-Universitaria Careggi, Firenze, Italy. 3. Cardiac Rehabilitation Unit, IRCCS Policlinico San Donato, Italy. 4. Cardiovascular Rehabilitation Unit, Le Terrazze Clinic, Cunardo, Italy. 5. Cardiac Rehabilitation Unit, Department of Cardiology, La Colletta Hospital, Arenzano, Italy. 6. Cardiac Rehabilitation, Azienda Ospedaliera S. Anna e S. Sebastiano di Caserta, Italy. 7. Cardiology Unit, Dr Pederzoli Clinic, Peschiera del Garda, Italy. 8. Heart Failure Unit, Cardiology, G. da Saliceto Hospital, Piacenza, Italy. 9. Department of Translational Medical Sciences, Division of Internal Medicine and Cardiac Rehabilitation, University of Naples "Federico II", Naples, Italy.
Abstract
BACKGROUND: Using data from the Italian SurveY on carDiac rEhabilitation (ISYDE-2008), this study provides insight into the level of implementation of Cardiac Rehabilitation (CR) in patients with diabetes. METHODS: Data from 165 CR units were collected online from January 28th to February 10th, 2008. RESULTS: The study cohort consisted of 2281 patients (66.9 ± 12 yrs); 475 (69.7 ± 10 yrs, 74% male) patients with diabetes and 1806 (66.2 ± 12 yrs, 72% male) non-diabetic patients. Compared to non-diabetic patients, patients with diabetes were older and showed more comorbidity [myocardial infarction (32% vs. 19%, p < 0.0001), peripheral artery disease (10% vs. 5%, p < 0.0001), chronic obstructive pulmonary disease (20% vs. 11%, p < 0.0001), chronic kidney disease (20% vs. 6%, p < 0.0001), and cognitive impairment (5% vs. 2%, p = 0.0009), respectively], and complications during CR [re-infarction (3% vs. 1%, p = 0.04), acute renal failure (9% vs. 4%, p < 0.0001), sternal revision (3% vs. 1%, p = 0.01), inotropic support/mechanical assistance (7% vs. 4%, p = 0.01), respectively]; a more complex clinical course and interventions with less functional evaluation and a different pattern of drug therapy at hospital discharge. Notably, in 51 (3%) and in 104 (6%) of the non-diabetic cohort, insulin and hypoglycemic agents were prescribed, respectively, at hospital discharge from CR suggesting a careful evaluation of the glycemic metabolism during CR program, independent of the diagnosis at the admission. Mortality was similar among diabetic compared to non-diabetic patients (1% vs. 0.5%, p = 0.23). CONCLUSIONS: This survey provided a detailed overview of the clinical characteristics, complexity and more severe clinical course of diabetic patients admitted to CR.
BACKGROUND: Using data from the Italian SurveY on carDiac rEhabilitation (ISYDE-2008), this study provides insight into the level of implementation of Cardiac Rehabilitation (CR) in patients with diabetes. METHODS: Data from 165 CR units were collected online from January 28th to February 10th, 2008. RESULTS: The study cohort consisted of 2281 patients (66.9 ± 12 yrs); 475 (69.7 ± 10 yrs, 74% male) patients with diabetes and 1806 (66.2 ± 12 yrs, 72% male) non-diabeticpatients. Compared to non-diabeticpatients, patients with diabetes were older and showed more comorbidity [myocardial infarction (32% vs. 19%, p < 0.0001), peripheral artery disease (10% vs. 5%, p < 0.0001), chronic obstructive pulmonary disease (20% vs. 11%, p < 0.0001), chronic kidney disease (20% vs. 6%, p < 0.0001), and cognitive impairment (5% vs. 2%, p = 0.0009), respectively], and complications during CR [re-infarction (3% vs. 1%, p = 0.04), acute renal failure (9% vs. 4%, p < 0.0001), sternal revision (3% vs. 1%, p = 0.01), inotropic support/mechanical assistance (7% vs. 4%, p = 0.01), respectively]; a more complex clinical course and interventions with less functional evaluation and a different pattern of drug therapy at hospital discharge. Notably, in 51 (3%) and in 104 (6%) of the non-diabetic cohort, insulin and hypoglycemic agents were prescribed, respectively, at hospital discharge from CR suggesting a careful evaluation of the glycemic metabolism during CR program, independent of the diagnosis at the admission. Mortality was similar among diabetic compared to non-diabeticpatients (1% vs. 0.5%, p = 0.23). CONCLUSIONS: This survey provided a detailed overview of the clinical characteristics, complexity and more severe clinical course of diabeticpatients admitted to CR.
Authors: Manuel F Jiménez-Navarro; Francisco Lopez-Jimenez; Luis M Pérez-Belmonte; Ryan J Lennon; Carlos Diaz-Melean; J P Rodriguez-Escudero; Kashish Goel; Daniel Crusan; Abhiram Prasad; Ray W Squires; Randal J Thomas Journal: J Am Heart Assoc Date: 2017-10-11 Impact factor: 5.501
Authors: Andrea Denegri; Valentina A Rossi; Fabrizio Vaghi; Paolo Di Muro; Martino Regazzi; Tiziano Moccetti; Elena Pasotti; Giovanni B Pedrazzini; Mauro Capoferri; Marco Moccetti Journal: Cardiol J Date: 2020-02-10 Impact factor: 2.737