Cardiac Rehabilitation in Advanced aGE after PCI for acute coronary syndromes: predictors of exercise capacity improvement in the CR-AGE ACS study.
Aging Clin Exp Res
; 34(9): 2195-2203, 2022 Sep.
Article
en En
| MEDLINE
| ID: mdl-35451734
ABSTRACT
BACKGROUND:
The positive effect of cardiac rehabilitation (CR) on outcomes after acute coronary syndromes (ACS) is established. Nevertheless, enrollment rates into CR programs remain low, although ACS carry a high risk of functional decline particularly in the elderly.AIM:
We aimed to determine if a multidisciplinary CR improves exercise capacity in an older population discharged after ACS systematically treated with PCI.METHODS:
CR-AGE ACS is a prospective, single-center, cohort study. All patients aged 75+ years consecutively referred to Cardiac Rehabilitation outpatient Unit at Careggi University Hospital, were screened for eligibility. Moderate/severe cognitive impairment, disability in 2+ basic activities of daily living, musculoskeletal diseases, contraindication to Cardiopulmonary Exercise Test, and diseases with an expected survival < 6 months, were exclusion criteria. Participants attended a CR program, based on 5-day-per-week aerobic training sessions for 4 weeks.RESULTS:
We enrolled 253 post-ACS patients with a mean age 80.6 ± 4.4 years. After CR, 136 (56.2%) 77 (31.3%) patients obtained, respectively, at least a moderate (∆+5%) or an optimal (∆+15%) increase in VO2peak. Baseline VO2peak (- 1 ml/kg/min OR 1.18; 95% CI 1.09-1.28), the number of training sessions (+1 session OR 1.07; 95% CI 1.01-1.15), and mild-to-moderate baseline disability (yes vs. no OR 0.22; 95% CI 0.01-0.57) were the predictors of VO2peak changes.CONCLUSIONS:
A CR program started early after discharge from ACS produces a significant increase in exercise capacity in very old patients with mild-to-moderate post-acute physical impairment. Baseline VO2peak, the number of training sessions, and the level of baseline disability are the independent predictors of improvement.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Síndrome Coronario Agudo
/
Intervención Coronaria Percutánea
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Rehabilitación Cardiaca
Tipo de estudio:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Aged
/
Aged80
/
Humans
Idioma:
En
Revista:
Aging Clin Exp Res
Asunto de la revista:
GERIATRIA
Año:
2022
Tipo del documento:
Article
País de afiliación:
Italia