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Benefits of cardiac rehabilitation in diabetic patients after an acute coronary syndrome
Session:
Posters 5 - Écran 08 - Reabilitação Cardíaca
Speaker:
Marta Braga
Congress:
CPC 2018
Topic:
J. Preventive Cardiology
Theme:
29. Rehabilitation and Sports Cardiology
Subtheme:
29.2 Cardiovascular Rehabilitation
Session Type:
Posters
FP Number:
---
Authors:
Marta Braga; J. Afonso Rocha; Helena M. Nascimento; Alzira Nunes; Paulo Araújo; Sofia Torres; Roberto Pinto; Joana Duarte Rodrigues; Vitor Araújo; Fernando Parada; Maria Júlia Maciel Barbosa
Abstract
<p><strong>Introduction and purpose: </strong>Diabetes mellitus is a major risk factor for cardiovascular (CV) disease. It is well known that cardiac rehabilitation program (CRP) improves outcome in patients after acute coronary syndrome (ACS). The aim of this study was to characterize the risk profile of diabetic patients and evaluate the impact of CRP in functional capacity (FC) in these patients comparing to non-diabetic patients.</p> <p><strong>Methods</strong>: We analysed data prospectively collected from patients who completed a CRP after an ACS, from 2008 and 2016. Patients were divided in two groups: Diabetic patients (G1) and non-diabetic patients (G2), according to International Diabetes Foundation criteria. FC was assessed using a standard exercise test (ET), including exercise duration and intensity in metabolic equivalents (METs).</p> <p><strong>Results: </strong>Of 734 patients, 133 patients were diabetic (18.1%). Mean age was 59.9±8.9 years in G1 and 53.2±9.6 years in G2, p<0.001. In both groups, most patients were male. Only 23.5% of diabetic patients were insulin dependent and initial mean glycated haemoglobin was 7.7±1.4%. Concerning to other CV risk factor, hypertension (53.4% vs 39.1%, p=0.003), dyslipidaemia (72.2% vs 58.7%, p=0.011) and obesity (35.4% vs 22.7%) were more frequent in G1, while smoking was more prevalent in G2 (33.1% vs 57.7%, p<0.001). About 50.0% of patients in G1 had multivessel coronary artery disease, comparing to 24.5% in G2 (p=0.021) and coronary artery bypass graft occurred more frequently in G1 (15.8% vs 6.3%). Mean left ventricular ejection fraction was similar in both groups (52.6±12.6 vs 52.6±11.4). Regarding baseline FC, ET duration was 7.3±2.1 min in G1 and 8.7±2.4 min in G2 (p<0.001), and ET intensity was 7.9±2.0 METs in G1 and 9.2±2.3 METs (p<0.001). In the end of CRP, both patients improved their FC, duration (increase of 18.0% in G1 and 17.3% in G2) and intensity (increase of 16.9% in G1 and 16.0 in G2) without statistically significant difference. Mean glycated haemoglobin of G1 patients after CRP was 6.2±1.0%.</p> <p><strong>Conclusions:</strong> Diabetic patient had higher CV risk profile comparing to non-diabetic and even so they had lower participation in CRP. In spite of showing worse ET results at the beginning and at the end of CRP, they had improved their FC in a similar form as the non-diabetic patients. This study highlights the need to identify and correct the barriers to CRP recruitment of this higher risk group of patients. </p>
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