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Improved Exercise Capacity and Cardiac Events After Rehabilitation in Post-Acute Coronary Syndrome Patients.
Session:
Sessão de Posters 27 - Reabilitação cardíaca
Speaker:
Miguel Rocha
Congress:
CPC 2024
Topic:
J. Preventive Cardiology
Theme:
29. Rehabilitation and Sports Cardiology
Subtheme:
29.2 Cardiovascular Rehabilitation
Session Type:
Cartazes
FP Number:
---
Authors:
Miguel Rocha; Helena Santos Moreira; Pedro Mangas Palma; Paula Dias; Joana Rodrigues; Afonso Rocha; Ana Pinho; Luís Santos; Cátia Oliveira; André Cabrita; Catarina Marques; Rui Rodrigues
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:12.0pt">Introduction: </span></strong><span style="font-size:12.0pt">Cardiac rehabilitation (CR) is a comprehensive intervention involving physical training and risk factor modification. Following acute coronary syndrome (ACS), CR has been shown to enhance exercise capacity, improve quality of life, and potentially reduce cardiovascular (CV) events.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:12.0pt">Purpose: </span></strong><span style="font-size:12.0pt">Our aim was to examine the association between exercise capacity at the end of CR and CV outcomes. The primary endpoint was a composite of mortality and CV events.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:12.0pt">Methods: </span></strong><span style="font-size:12.0pt">We conducted a retrospective analysis of ACS patients who were subsequently enrolled in CR at our centre, from 2008 to 2019. Clinical data from the hospital admission, the initial and the final CR visit was collected from medical records. Exercise capacity at CR completion was assessed using treadmill stress test metabolic equivalents (METs). Subsequent CV events or death during follow-up were compared with METs at the end of CR. Statistical data was analysed using the SPSS software.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:12.0pt">Results: </span></strong><span style="font-size:12.0pt">In this study of 713 patients (mean age 54 ± 9.4 years; 85.4% male), smoking was the predominant CV risk factor (78%) and ST elevation myocardial infarction the most prevalent initial CV event (50.4%). </span><span style="font-size:12.0pt"><span style="color:#0f0f0f">The average follow-up time was 9.5 (± 2.54) years.</span></span><span style="font-size:12.0pt"> There was a significant improvement in exercise capacity as indicated by the increase in average METs from baseline to post-CR (10.6 ± 2.3, p = 0.01). The primary endpoint occurred in 199 (27.9%) patients overall during follow-up, with unstable angina (9%) being the most frequent event. There were 25 (3.5%) deaths during follow-up. The average METs post-CR showed a significant association with the primary endpoint (p = 0.01), indicating that higher METs correlated with fewer CV events or deaths. This association remained robust in the multivariate logistic regression model, even after adjusting for possible confounding factors (odds ratio </span><span style="font-size:12.0pt">[</span><span style="font-size:12.0pt">OR</span><span style="font-size:12.0pt">]</span><span style="font-size:12.0pt"> 0.829; 95% CI </span><span style="font-size:12.0pt">[</span><span style="font-size:12.0pt">0.753, 0.912</span><span style="font-size:12.0pt">]</span><span style="font-size:12.0pt">).</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:12.0pt">Conclusion: </span></strong><span style="font-size:12.0pt">Our study emphasizes the importance of CR in the ongoing care of post ACS patients. In our cohort with a relatively extended follow-up, we showed that improved exercise capacity after CR may predict fewer cardiovascular events, which is consistent with previous research. Further large randomized trials are needed to better understand the long-term effects and safety of high-intensity training in high-risk cardiovascular or chronic heart failure patients.</span></span></span></p>
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