Key result
Maintenance cardiac rehabilitation in elderly CAD patients yielded lower peak oxygen consumption than very active peers (19.0 vs 23.7 ml/kg/min, p=0.001) but similar to less active peers (p=0.390).
Why the study?
Does ongoing community-based maintenance cardiac rehabilitation improve exercise capacity and cardiovascular response to exercise in elderly individuals with stable coronary artery disease compared to healthy active and less active peers?
Cross-Sectional (n=63)
Does ongoing community-based maintenance cardiac rehabilitation improve exercise capacity and cardiovascular response to exercise in elderly individuals with stable coronary artery disease compared to healthy active and less active peers?
Absolute Event Rate: 19% vs 23.7%
p-value: p=0.001 versus HVA; 0.390 versus HLA
Elderly patients with coronary artery disease participating in maintenance cardiac rehabilitation achieve exercise capacities similar to healthy, less active age-matched peers, supporting the value of community-based CR programs.
Maintenance CR may preserve exercise capacity in elderly CAD; leaves open whether benefits exceed selection bias in observational cohorts.
PURPOSE: To compare exercise capacity and cardiovascular response to exercise in elderly individuals with coronary artery disease (CAD) who attend ongoing community-based maintenance cardiac rehabilitation (CR) versus age- and gender-matched healthy "very active" (HVA; ≥ 2000 kcal/week) and healthy "less active" (HLA; <2000 kcal/week) individuals. METHOD: Sixty-three participants (age: 72.3 ± 5.1 years; 62% men; n = 21 per group) completed the following assessments: (1) symptom-limited graded exercise test with expired gas analysis and bioimpedance assessment of cardiovascular function during exercise; (2) walking tests; (3) physical function; (4) anthropometry and (5) 12-month physical activity recall. RESULTS: The CR group achieved 98% (range: 73-154%) of age- and gender-predicted peak oxygen consumption for healthy individuals. Peak oxygen consumption was lower in CR compared to HVA but not HLA group (VO2peak: CR: 19.0 ± 4.5, HVA: 23.7 ± 2.9, HLA: 20.7 ± 4.7 ml ·kg(-1)ċmin(-1), p = 0.001 versus HVA; p = 0.390 versus HLA). Peak heart rate was lower in CR compared to both HVA and HLA. Walking test results and cardiovascular and physical function were not different between the groups. CONCLUSIONS: Elderly individuals with CAD participating in maintenance CR have similar exercise capacity and cardiorespiratory response to exercise compared to their age- and gender-matched less active healthy peers. The findings support referral of elderly patients to community-based CR. IMPLICATIONS FOR REHABILITATION: Fitness benefits of long-term maintenance cardiac rehabilitation (CR) programs remain unknown. Elderly individuals with coronary artery disease participating in maintenance CR have exercise capacity and cardiorespiratory response to exercise similar to their less active healthy peers. Maintenance CR may play an important role prolonging independent living in elderly individuals.
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Mandic et al. (2015) conducted a cross-sectional in stable coronary artery disease (n=63). Community-based maintenance cardiac rehabilitation vs. Healthy very active (HVA) and healthy less active (HLA) individuals was evaluated on Peak oxygen consumption (VO2peak) (p=0.001 versus HVA; 0.390 versus HLA). Maintenance cardiac rehabilitation in elderly CAD patients yielded lower peak oxygen consumption than very active peers (19.0 vs 23.7 ml/kg/min, p=0.001) but similar to less active peers (p=0.390).
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