The Role of Cardiac Rehabilitation in Reducing Major Adverse Cardiac Events in Heart Transplant Patients.
J Card Fail
; 26(8): 645-651, 2020 Aug.
Article
in En
| MEDLINE
| ID: mdl-31981697
ABSTRACT
BACKGROUND:
Methods for reducing major adverse cardiac events (MACE) in patients after heart transplantation (HTx) are critical for long-term quality outcomes. METHODS ANDRESULTS:
Patients with cardiopulmonary exercise testing prior to HTx and at least 1 session of cardiac rehabilitation (CR) after HTx were included. Exercise sessions were evaluated as ≥ 23 or < 23 sessions based on recursive partitioning. We included 140 patients who had undergone HTx (women nâ¯=â¯41 (29%), age 52 ± 12 years, body mass index 27 ± 5 kg/m2). Mean follow-up was 4.1 ± 2.7 years, and 44 patients (31%) had a MACE stroke (nâ¯=â¯1), percutaneous intervention (nâ¯=â¯5), heart failure (nâ¯=â¯6), myocardial infarction (nâ¯=â¯1), rejection (nâ¯=â¯16), or death (nâ¯=â¯15). CR was a significant predictor of MACE, with ≥ 23 sessions associated with a â¼ 60% reduction in MACE risk (hazard ratio [HR] 0.42, 95% CI 0.19-0.94, Pâ¯=â¯0.035). This remained after adjusting for age, sex and history of diabetes (HR 0.41, 95% CI 0.18-0.94, Pâ¯=â¯0.035) as well as body mass index and pre-HTx peak oxygen consumption (HR 0.40, 95% CI 0.18-0.92, Pâ¯=â¯0.031).CONCLUSIONS:
After adjustment for covariates of age, sex, diabetes, body mass index, and pre-HTx peak oxygen consumption, CR attendance of ≥ 23 exercise sessions was predictive of lower MACE risk following HTx. In post-HTx patients, CR was associated with MACE prevention and should be viewed as a critical tool in post-HTx treatment strategies.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Heart Transplantation
/
Cardiac Rehabilitation
/
Heart Failure
Type of study:
Prognostic_studies
Limits:
Female
/
Humans
/
Middle aged
Language:
En
Journal:
J Card Fail
Journal subject:
CARDIOLOGIA
Year:
2020
Type:
Article