Differential prognostic impact between completion and non-completion of a 5-month cardiac rehabilitation program in outpatients with cardiovascular diseases
Differential prognostic impact between completion and non-completion of a 5-month cardiac rehabilitation program in outpatients with cardiovascular diseases
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DOI：
10.1016/j.ijcard.2019.06.017
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发表时间：
2019-10-01
影响因子：
3.5
通讯作者：
Miura, Shin-ichiro
中科院分区：
文献类型：
--
作者：
Fujimi, Kanta;Imaizumi, Tomoki;Miura, Shin-ichiro
背景：心脏康复（CR）是心血管疾病（CVD）患者护理的重要组成部分。我们的目的是评估门诊CVD患者的临床结局，没有完成5个月的CR program.Methods：332例门诊CVD患者参加了5个月的CR program，并随访了最长5年。我们将患者分为两组：完成CR程序的患者（成功组，n = 175）和未能完成CR程序的患者（失败组，n = 157）。两个长期（5年）和短期（5个月）的临床outcomes进行了比较，两组之间。结果：有没有显着差异，在成功和不成功的组之间的基线患者的特征。Kaplan-Meier分析显示，在长期和短期临床结局方面，成功组的全因死亡率和住院率显著低于失败组。两组间短期心血管疾病死亡和住院率有显著差异，但长期心血管疾病死亡和住院率无显著差异。在长期内，全因死亡和住院与CR计划的完成独立相关，除了外周动脉疾病的存在和VE与VCO 2斜率，调整年龄，性别，体重指数，CVD类型和药物治疗后。结论：完成5个月CR计划与预防全因死亡和住院相关，但与长期CVD死亡和住院无关，这表明我们需要重新考虑这个问题。(C)2019由Elsevier B. V.出版
Background: Cardiac rehabilitation (CR) is an essential component of care for patients with cardiovascular diseases (CVD). We aimed to evaluate clinical outcomes in outpatients with CVD who did and did not complete a 5-month CR program.Methods: Three hundred thirty-two outpatients with CVD who participated in a 5-month CR program and were followed-up for maximum 5 years were registered. We divided the patients into two groups: those who completed the CR program (success group, n = 175) and those who could not (non-success group, n = 157). Both long-term (5 years) and short-term (5 months) clinical outcomes were compared between the two groups.Results: There were no significant differences in patient characteristics at baseline between the success and non-success groups. With regard to both long-term and short-term clinical outcomes, the rates of all-cause death and hospital admission in the success group were significantly lower than those in the non-success group by a Kaplan-Meier analysis. There was a significant difference in short-term CVD death and hospital admission between the groups, but not for long-term CVD death and hospital. In long-term period, all-cause death and hospital admission was independently associated with completion of the CR program in addition to the presence of peripheral artery disease and VE vs. VCO2 slope after adjusting for age, gender, body mass index, types of CVD and medications.Conclusions: Completion of a 5-month CR program was associated with the prevention of all-cause death and hospital admission, but not CVD death and hospital admission in the long-term, which suggests that we need to reconsider this issue. (C) 2019 Published by Elsevier B.V.