Outpatient cardiac rehabilitation after transcatheter aortic valve implantation significantly reduced the risk of all-cause mortality (HR 0.440) compared to non-participation.
Puntos clave
To explore the relationship between outpatient cardiac rehabilitation participation and all-cause mortality following transcatheter aortic valve implantation.
Investigated patients who underwent transcatheter aortic valve implantation (TAVI)
Analyzed the effects of outpatient cardiac rehabilitation (OCR) participation
Examined post-discharge mortality rates
Found an association between OCR participation and reduced all-cause mortality after TAVI
Indicated potential benefits of rehabilitation programs for improving outcomes
Suggested that OCR may enhance recovery further post-discharge
Diseño del estudio
Tipo
Cohort (n=1,446)
Multicéntrico
No
PICO estructurado
Does comprehensive outpatient cardiac rehabilitation reduce all-cause mortality in patients with severe aortic stenosis after TAVI?
P
Población
1,446 older adults with severe aortic stenosis who underwent elective transcatheter aortic valve implantation and were discharged home, followed for a mean of 2.9 years.
E
Exposición
Comprehensive outpatient cardiac rehabilitation (OCR) after discharge, including supervised sessions (1-3 times per week) and unsupervised home-based exercises (4-6 times per week) for 3-5 months, alongside multidisciplinary support (cardiovascular risk management, nutritional counseling, psychosocial support).
C
Comparador
No participation in outpatient cardiac rehabilitation after discharge (standard care).
O
Resultado
Post-discharge all-cause mortality.hard clinical
Participation in comprehensive outpatient cardiac rehabilitation after TAVI is independently associated with significantly reduced long-term all-cause mortality.
Resultado numérico
Hazard Ratio: 0.44 (95% CI 0.255–0.757)
Tasa de eventos absoluta: 14% vs 23.6%
valor p: p=0.003
Limitaciones
Single-center retrospective study design
Potential residual unmeasured confounding such as cognitive function and caregiver availability
Excluded patients with lower activities of daily living levels (Barthel Index <60)
Short participation period for some patients in the rehabilitation program
Lack of post-discharge physical function assessment in the non-participating group
Unavailability of reliable data on specific clinical events like cardiovascular mortality, heart failure rehospitalizations, stroke, and major bleeding
Resumen
Background: Transcatheter aortic valve implantation (TAVI) has enhanced outcomes in patients with severe aortic stenosis (AS). However, the additional effect of introducing outpatient cardiac rehabilitation (OCR) remains unclear. In this study, we investigated how OCR participation is associated with post-discharge all-cause mortality among patients who underwent TAVI.
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Cite This Study
Kobayashi et al. (Fri,) conducted a cohort in Severe aortic stenosis (n=1,446). Outpatient cardiac rehabilitation vs. Non-participation in outpatient cardiac rehabilitation was evaluated on All-cause mortality (HR 0.440, 95% CI 0.255-0.757, p=0.003). Outpatient cardiac rehabilitation after transcatheter aortic valve implantation significantly reduced the risk of all-cause mortality (HR 0.440) compared to non-participation.