Cardiometabolic responses to cardiac rehabilitation in people with and without diabetes.
Int J Cardiol
; 301: 156-162, 2020 02 15.
Article
em En
| MEDLINE
| ID: mdl-31806276
ABSTRACT
BACKGROUND:
Type 2 diabetes and cardiometabolic comorbidities manifesting as the metabolic syndrome (MetS) are highly prevalent in coronary heart disease (CHD) patients attending cardiac rehabilitation (CR). The study aimed to determine the prevalence of cardiometabolic derangements and MetS, and compare post-CR clinical responses in a large cohort of CHD patients with and without diabetes.METHODS:
Analyses were conducted on 3953 CHD patients [age 61.1⯱â¯10.5â¯years; 741 (18.7%) with diabetes] that completed a representative 12-week CR program. A propensity model was used to match patients with diabetes (nâ¯=â¯731) to those without diabetes (nâ¯=â¯731) on baseline and clinical characteristics.RESULTS:
Diabetic patients experienced smaller improvements in metabolic parameters after completing CR, including abdominal obesity, and lipid profiles (all Pâ¯≤â¯.002), compared to non-diabetic patients. For both groups, there were similar improvement rates in peak metabolic equivalents ([METs]; Pâ¯<â¯.001); however, peak METs remained lower at 12-weeks in patients with diabetes than without diabetes. At baseline, the combined prevalence of insulin resistance (IR) and diabetes was 57.3%, whereas IR was present in 48.2% of non-diabetic patients, of which rates were reduced to 48.2% and 32.8% after CR, respectively. Accordingly, MetS prevalence decreased from 25.5% to 22.3% in diabetic versus 20.0% to 13.4% in non-diabetic patients (all Pâ¯≤â¯.004).CONCLUSIONS:
Completing CR appears to provide comprehensive risk reduction in cardio-metabolic parameters associated with diabetes and MetS; however, CHD patients with diabetes may require additional and more aggressive attention towards all MetS criteria over the course of CR in order to prevent future cardiovascular events.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Doença das Coronárias
/
Síndrome Metabólica
/
Diabetes Mellitus Tipo 2
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Terapia por Exercício
/
Reabilitação Cardíaca
/
Aptidão Cardiorrespiratória
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Int J Cardiol
Ano de publicação:
2020
Tipo de documento:
Article