What does this research mean for the field?

A standard 8-week outpatient cardiac rehabilitation program is less beneficial for women with coronary artery disease compared to men, and is insufficient to improve their exercise capacity to a level that predicts mortality risk reduction. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

April 8, 2022Journal of Personalized MedicineOpen Access

Clinical Outcomes of Cardiac Rehabilitation in Women with Coronary Artery Disease—Differences in Comparison with Men

View Full Paper

Ask AI

Bookmark

Why the study?

This study evaluated clinical outcomes of cardiac rehabilitation in women with coronary artery disease compared to men.

Does an 8-week outpatient cardiac rehabilitation program improve exercise capacity differently in women compared to men with coronary artery disease?

Structured PICO

Does an 8-week outpatient cardiac rehabilitation program improve exercise capacity differently in women compared to men with coronary artery disease?

Population

286 patients (106 women, 180 men) with coronary artery disease after acute coronary syndrome or revascularization procedures.

Intervention

Comprehensive outpatient cardiac rehabilitation program comprising 45-minute ergometer interval training 3 times a week for 8 weeks, with intensity based on training heart rate from an exercise test.

Comparator

Men undergoing the same cardiac rehabilitation program (observational comparison between sexes).

Outcome

Change in exercise capacity (measured in METs) after 8 weeks.surrogate

A standard 8-week outpatient cardiac rehabilitation program yields significantly smaller improvements in exercise capacity for women compared to men, suggesting current regimens may be insufficient for women with CAD.

Implication

Women achieve smaller exercise gains with standard outpatient CR than men; this cohort study leaves open whether sex-specific regimens are needed.

Abstract

This study evaluated the clinical outcomes of cardiac rehabilitation (CR) in women with coronary artery disease (CAD) in comparison to men. Methods: Patients after acute coronary syndrome or after revascularization procedures (106 women, 180 men) were consecutively admitted to a comprehensive outpatient CR program, comprising of 45-min ergometer interval training three times a week for eight weeks. The training intensity was determined on the basis of training heart rate, calculated following an exercise test. Patients were divided into subgroups according to age (≤55, >55 years), BMI (<25, ≥25 kg/m2), left ventricular ejection fraction (LVEF; ≤40%, 41−49%, ≥50%), and number of affected coronary vessels. Results: After eight weeks, exercise capacity increased significantly by 0.6 ± 0.77 MET (women) and by 1.0 ± 0.74 MET (men). The greatest benefit was observed in men, women under 55 years, women with LVEF 41−49%, and women with single-vessel CAD. An outpatient CR program appears less beneficial for women, especially those over 55 years, with two or three coronary vessels affected with atherosclerosis or with LVEF > 50%. In women with CAD, eight weeks of 45-min interval training, with sessions three times a week, is insufficient to improve exercise capacity to an extent that is considered a predictor of mortality risk reduction.