Men had significantly greater increases in VO2 peak than women following cardiac rehabilitation (P=0.001), and clinical predictors of improvement and MACEs were sex-specific.
Cohort (n=671)
Do clinical predictors of VO2 peak improvement and MACEs following outpatient cardiac rehabilitation differ by sex?
Clinical predictors of exercise capacity improvement and MACE reduction following cardiac rehabilitation differ significantly between men and women.
p-value: p=0.001
Background Cardiac rehabilitation (CR) leads to increased exercise capacity (VO 2 peak) and risk reduction of major adverse cardiovascular events (MACEs). Women exhibit blunted VO 2 peak improvements following CR. The purpose was to examine sex differences in the clinical predictors of VO 2 peak improvement and odds of MACEs following CR. Methods From 1999 to 2017, all consecutive patients undergoing cardiopulmonary exercise testing before and after CR were included. Sex differences in peak exercise metrics in response to CR were compared. Multiple logistic regression models were fit to assess clinical predictors of VO 2 peak improvement (defined as >0% from pre‐CR) and MACEs following CR for men and women. Results A total of 513 men and 158 women were included. Men had greater increases in VO 2 peak than women following CR ( P =0.001). For men, independent predictors of VO 2 peak improvement following CR included higher CR session attendance (odds ratio OR, 1.04 95% CI, 1.02–1.06), peripheral artery disease (OR, 0.47 95% CI, 0.25–0.86), and pre‐CR VO 2 peak (OR, 0.98 95% CI, 0.97–0.99) (all, P <0.02). Independent predictors of lower odds of MACEs following CR in men included higher number of CR sessions (OR, 0.97 95% CI, 0.95–0.99), pre‐CR VO 2 peak (OR, 0.98 95% CI, 0.97–0.99), surgical CR indication (OR, 0.34 95% CI, 0.18–0.68), and no history of peripheral artery disease (OR, 2.94 95% CI, 1.60–5.38) (all, P <0.02). For women, the selected clinical characteristics were not statistically significant independent predictors of VO 2 peak improvement or odds of MACEs (except for diabetes) following CR. Conclusions These findings suggest that clinical predictors of VO 2 peak improvement and odds of MACEs following CR are sex specific.
Smith et al. (Fri,) conducted a cohort in Cardiac rehabilitation (n=671). Male sex vs. Female sex was evaluated on VO2 peak improvement (p=0.001). Men had significantly greater increases in VO2 peak than women following cardiac rehabilitation (P=0.001), and clinical predictors of improvement and MACEs were sex-specific.