Cardiac rehabilitation reduced cardiovascular events at 1 year to 3% vs 22% in controls among patients with peripheral artery disease post-revascularization.
Does a cardiac rehabilitation programme reduce vascular events in patients with non-fatal ischemic stroke or peripheral vascular revascularization?
Cardiac rehabilitation significantly reduces the incidence of cardiovascular events at 1 year in patients who have undergone peripheral vascular revascularization, extending the benefits of this intervention beyond traditional coronary heart disease populations.
Absolute Event Rate: 0% vs 0%
Abstract Background Cardiac rehabilitation (CR) improves quality of life, functional capacity and reduces mortality rates in patients with cardiovascular disease. Traditionally, patients with coronary heart disease were referred to this programs while patients with peripheral artery disease or cerebrovascular disease could not benefit from this intervention. However, considering that atherosclerosis is the physiopathological mechanism underlying those three conditions and, consequently, all of them would benefit of a tight vascular risk factor control and lifestyle changes, CR must be offered to all of these patients. Purpose This study aimed to evaluate the impact of including patients who had suffered a non-fatal ischemic stroke or had undergone a peripheral vascular revascularization in a CR program in terms of risk factor control and incidence of cardiovascular events compared with the usual care. Methods Patients who had suffered a non-fatal ischemic stroke or had undergone a peripheral vascular revascularization (cases) were referred to a cardiac rehabilitation programme specifically adapted for these conditions in a tertiary referral hospital from September 2023 to June 2024. These patients were compared to a control cohort who received usual care after a hospitalization for the conditions aforementioned in the same centre during 2023. The incidence of vascular events (cardiovascular death, non-fatal stroke, new revascularization, acute coronary syndrome) was analysed after 1 year follow-up. The results were stratified in two groups: no events or more than 1 event. Data were analysed using R software. Results A total of 70 patients: 33 patients who had suffered a non-fatal ischemic stroke and 30 who had undergone a peripheral vascular revascularization (cases) were compared to 68 patients (controls). 7 patients from the cases group did not attended the programme and were excluded. Regarding the basal characteristics there were significant differences in age, hypertension and chronic kidney disease (Table 1). After 1 year follow-up, the incidence of cardiovascular events was significantly lower in the cases group: 61 (97%) did not have any events vs 53 (78%) in the control group (Figure 1). This difference was analysed depending on the referral unit and we observed that patients with peripheral artery disease presented a significant reduction in vascular events during follow up whereas patients referred from Neurology did not. Conclusions Patients who suffer peripheral artery disease and undergo peripheral vascular revascularization benefit from referral to a cardiac rehabilitation programme in terms of reduction of cardiovascular events.Table 1.Basal Characteristics Figure 1.Vascular events 1year follow-up
Contreras et al. (Sat,) reported a other. Cardiac rehabilitation reduced cardiovascular events at 1 year to 3% vs 22% in controls among patients with peripheral artery disease post-revascularization.