Author + information
- Sara Doimo,
- Patrizia Maras,
- Giulia Barbati and
- Gianfranco Sinagra
Background: cardiac rehabilitation (CR) is a model of care proven to reduce mortality and morbidity in patients with coronary artery disease. However, only few studies reported a follow-up longer than 12 months after CR. We analyzed the occurrence of major adverse cardiac events (MACE) identifying predictors of MACE in patients with a long- term follow-up after CR.
Methods: from 2009 to 2010, all patients discharged after an acute coronary syndrome (ACS), coronary artery bypass graft (CABG) or elective percutaneous transluminal coronary angioplasty (PTCA) were referred to CR program. CR lasted 5 ± 4 months. The incidence of MACE (defined as death and hospitalization for cardiovascular causes) was assessed in a mean follow- up of 75 ± 8 months after CR.
Results: we enrolled 839 patients (mean age 69±11 years), 27% of them were elderly (older than 75 years), 49% had ACS, 29% were post CABG and 22% post PTCA. During follow-up, MACE involved 18% of subjects and occurred significantly post PTCA (28%, p= 0,05), elderly (35%, p= 0.019), diabetics (25%, p= 0.002) and in those who had chronic renal failure (29%, p= 0.000), whereas were few post CABG (19%, p= 0.002). Multivariate analysis identified chronic renal failure (hazart ratio [HR] 1.4; 95% confidence interval [CI]: 1.8 to 3.8; p= 0.000) as the strongest independent predictor of MACE, followed by diabetes (HR 1.6; 95% CI: 1.1 to 2.3; p= 0,005), while CABG was protective (HR 0,5; 95% CI: 0.3 to 0.8; p= 0,005).
Conclusions: This study identified high- risk categories of MACE and chronic renal failure and diabetes such as predictors of MACE, while CABG is protective.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Predicting Outcomes in Cardiac Rehabiltation Patients
Abstract Category: 34. Prevention: Rehabilitation
Presentation Number: 1276-041
- 2017 American College of Cardiology Foundation