SPC365

Gender disparities in Cardiac Rehabilitation - Are we concealing apples from Eve?

Session: Posters (Sessão 6 - Écran 4) - Provas de Esforço e Reabilitação
Speaker: Ana Lobato de Faria Abrantes

Congress: CPC 2023
Topic: J. Preventive Cardiology
Theme: 29. Rehabilitation and Sports Cardiology
Subtheme: 29.2 Cardiovascular Rehabilitation
Session Type: Pósters Electrónicos
FP Number: ---
Authors: Ana Lobato De Faria Abrantes; Pedro Alves da Silva; Joana Brito; Beatriz Valente Silva; Ana Margarida Martins; Ana Beatriz Garcia; Catarina Simões de Oliveira; Catarina Gregório; Miguel Azaredo Raposo; João Santos Fonseca; Paula Sousa; Nelson Cunha; Inês Ricardo; Rita Pinto; Fausto J. Pinto; Ana Abreu

<p><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><strong>Introduction</strong></span></span></span><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000">: Cardiovascular disease is a leading cause of death in both men and women and cardiac rehabilitation (CR) is recommended as part of secondary prevention for these patients. Despite this, there are still important asymmetries when it comes to enrolment of women in CR programs.</span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><strong>Purpose</strong></span></span></span><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000">: To determine differences between referral and outcomes of cardiac rehabilitation programs among women.</span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><strong>Methods</strong></span></span></span><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000">: <span style="background-color:#ffffff">Prospective cohort study which included consecutive pts who were participating in a center-based CR program lasting 8 weeks from 2019 to 2021. We analyzed prevalence of risk factors, laboratory, echocardiographic and </span></span></span></span>Cardiopulmonary Exercise Testing (CPET)&nbsp;<span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><span style="background-color:#ffffff"> data in women who were enrolled in the program. Statistical analysis was performed with Mann-Whitney and Wilcoxon tests.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><strong>Results</strong></span></span></span><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000">: From a total of 349 patients, 60 women completed a CR program &ndash; 17,8% of pts &ndash; representing a far smaller percentage when accounting to acute coronary syndrome events in our center in those 2 years (31% women). Mean age of female participants was 60 &plusmn; 11,8 years; 74% had hypertension, 64% dyslipidemia, 19% diabetes and only 40% had never smoked. There were no significant differences when compared to male, except for thyroid disease which was more frequent among women (p&lt;0.01).</span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000">Regarding laboratory data we noticed an improvement of LDL-c, total cholesterol, HDL-c, although only NTproBNP showed a statistically significant reduction (p=0.001). There was also an improvement of LVEF, once again without statistical significance (in contrast to the male population).</span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000">After completion of the program, there was an improvement regarding CPET duration and workload (p&lt;0.001 and p=0.019). Interestingly there was no difference in terms of peak VO2/kg, a data that goes in line with some reports of less impact of exercise based CR in this parameter in women.</span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000">Moreover, there were no differences between genders in terms of outcome, namely admissions or cardiovascular death.</span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><strong>Conclusion: </strong></span></span></span><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000">Women still have a lower rate of enrolment in CR programs, despite results showing a similar benefit to men. CR effectiveness by CPET should include other parameters besides VO2 peak. Strategies should be developed to improve women participation in CR.</span></span></span></p>

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