Atsuko Nakayama1, Masatoshi Nagayama2, Hiroyuki Morita3, Miyu Tajima4, Keitaro Mahara2, Yukari Uemura5, Hitonobu Tomoike2, Issei Komuro6, Mitsuaki Isobe2. 1. Department of Cardiovascular Medicine, The University of Tokyo; Department of Cardiovascular Medicine, Sakakibara Heart Institute. Electronic address: st7089-fki@umin.ac.jp. 2. Department of Cardiovascular Medicine, Sakakibara Heart Institute. 3. Department of Cardiovascular Medicine, The University of Tokyo. Electronic address: hmrt-tky@umin.net. 4. Department of Cardiovascular Medicine, The University of Tokyo; Department of Cardiovascular Medicine, Sakakibara Heart Institute. 5. Biostatistics Department, Central Coordinating Unit, Clinical Research Support Center, The University of Tokyo. 6. Department of Cardiovascular Medicine, The University of Tokyo.
Abstract
BACKGROUND: Few studies have evaluated the therapeutic effect of long-term cardiac rehabilitation (CR) and no large-scale survey of cardiovascular outcomes after long-term CR is reported. METHODS: This cohort study included 9981 patients undergoing CR from 2004 to 2015. Patients who had supervised CR were divided into three groups according to CR duration: up to acute phase (until discharge, Phase I group), up to recovery phase (≤150 days, Phase II group), and up to maintenance phase (>150 days, Phase III group). Using propensity score matching, mortality and major adverse cardiovascular events (MACE) were compared among the groups. RESULTS: Follow-up period was 4.9 ± 3.0 years. Adult patients were divided into three groups (Phase I group: n = 4649, Phase II group: n = 3271, and Phase III group: n = 731). After propensity score matching, the risk of death and MACE was extremely lower in Phase III group than in Phase I or Phase II group (death: HR 0.47, P < 0.01, HR 0.64, P < 0.01, and MACE: HR 0.48, P < 0.01, HR 0.70, P < 0.01). Most patients in Phase II group had better survival than those in Phase I group. Subpopulations of female patients and those with dyslipidemia, smoking history, coronary artery bypass graft, or heart failure had better survival in Phase III group than in Phase II group. CONCLUSIONS: Long-term supervised CR for patients with cardiovascular diseases is more effective than short-term CR.
BACKGROUND: Few studies have evaluated the therapeutic effect of long-term cardiac rehabilitation (CR) and no large-scale survey of cardiovascular outcomes after long-term CR is reported. METHODS: This cohort study included 9981 patients undergoing CR from 2004 to 2015. Patients who had supervised CR were divided into three groups according to CR duration: up to acute phase (until discharge, Phase I group), up to recovery phase (≤150 days, Phase II group), and up to maintenance phase (>150 days, Phase III group). Using propensity score matching, mortality and major adverse cardiovascular events (MACE) were compared among the groups. RESULTS: Follow-up period was 4.9 ± 3.0 years. Adult patients were divided into three groups (Phase I group: n = 4649, Phase II group: n = 3271, and Phase III group: n = 731). After propensity score matching, the risk of death and MACE was extremely lower in Phase III group than in Phase I or Phase II group (death: HR 0.47, P < 0.01, HR 0.64, P < 0.01, and MACE: HR 0.48, P < 0.01, HR 0.70, P < 0.01). Most patients in Phase II group had better survival than those in Phase I group. Subpopulations of female patients and those with dyslipidemia, smoking history, coronary artery bypass graft, or heart failure had better survival in Phase III group than in Phase II group. CONCLUSIONS: Long-term supervised CR for patients with cardiovascular diseases is more effective than short-term CR.
Authors: Ingrid Maria Novais Barros de Carvalho Costa; Danielle Góes da Silva; Joselina Luzia Meneses Oliveira; José Rodrigo Santos Silva; Larissa Monteiro Costa Pereira; Luciana Vieira Sousa Alves; Fabrício Anjos de Andrade; Juliana de Góes Jorge; Larissa Marina Santana Mendonça de Oliveira; Rebeca Rocha de Almeida; Victor Batista Oliveira; Larissa Santos Martins; Jamille Oliveira Costa; Márcia Ferreira Cândido de Souza; Silvia Maria Voci; Marcos Antonio Almeida-Santos; Victoria Vieira Abreu; Felipe J Aidar; Leonardo Baumworcel; Antônio Carlos Sobral Sousa Journal: Prev Med Rep Date: 2022-09-03