Key result
Active participation in outpatient cardiac rehabilitation after CABG surgery was associated with a significantly lower rate of major adverse cardiac events compared to non-active participation (3.4% vs. 10.5%, RR 0.09).
Why the study?
There was little evidence regarding the effect of outpatient cardiac rehabilitation on exercise capacity or long-term prognosis in patients after CABG.
Does active participation in outpatient cardiac rehabilitation reduce major adverse cardiac events in post-CABG patients?
Cohort (n=346)
Yes
Does active participation in outpatient cardiac rehabilitation reduce major adverse cardiac events in post-CABG patients?
Relative Risk: 0.09 (95% CI 0–0.75)
Absolute Event Rate: 3.4% vs 10.5%
p-value: p=0.02
Active participation in outpatient cardiac rehabilitation after CABG is associated with significantly improved exercise capacity and a lower rate of major adverse cardiac events over 3.5 years.
Should not yet change post-CABG rehabilitation practice; leaves open need for randomized confirmation of benefit.
BACKGROUND: There is little evidence regarding the effect of outpatient cardiac rehabilitation (CR) on exercise capacity or the long-term prognosis in patients after coronary artery bypass graft surgery (CABG). This study aimed to determine whether participation in outpatient CR improves exercise capacity and long-term prognosis in post-CABG Japanese patients in a multicenter cohort. METHODS AND RESULTS: We enrolled 346 post-CABG patients who underwent cardiopulmonary exercise testing during early (2-3 weeks) and late (3-6 months) time points after surgery. They formed the Active (n=240) and Non-Active (n=106) CR participation groups and were followed for 3.5 years. Primary endpoint was a major adverse cardiac event (MACE): all-cause death or rehospitalization for acute myocardial infarction/unstable angina/worsening heart failure. Peak oxygen uptake at 3-5 months from baseline was significantly more increased in Active than in Non-Active patients (+26±24% vs. +19±20%, respectively; P<0.05), and the MACE rate was significantly lower in Active than Non-Active patients (3.4% vs. 10.5%, respectively; P=0.02). Multivariate Cox proportional hazard analysis showed that participation in outpatient CR was a significant prognostic determinant of MACE (P=0.03). CONCLUSIONS: This unique study showed that a multicenter cohort of patients who underwent CABG and actively participated in outpatient CR exhibited greater improvement in exercise capacity and better survival without cardiovascular events than their counterparts who did not participate.
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Origuchi et al. (2020) conducted a cohort in Coronary artery bypass graft surgery (CABG) (n=346). Active participation in outpatient cardiac rehabilitation vs. Non-active participation was evaluated on Major adverse cardiac event (MACE): all-cause death or rehospitalization for acute myocardial infarction, unstable angina, or worsening heart failure (RR 0.09, 95% CI 0-0.75, p=0.02). Active participation in outpatient cardiac rehabilitation after CABG surgery was associated with a significantly lower rate of major adverse cardiac events compared to non-active participation (3.4% vs. 10.5%, RR 0.09).
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