Key result
A 1 ml/kg/min lower baseline VO2peak independently predicted an increased probability of achieving a moderate improvement in exercise capacity (OR 1.18) following a 4-week cardiac rehabilitation program in older adults post-ACS.
Why the study?
Cardiac rehabilitation enrollment remains low despite established benefits, and its effect on exercise capacity in older patients post-ACS treated with PCI needed evaluation.
Does a multidisciplinary cardiac rehabilitation program improve exercise capacity in older patients discharged after ACS treated with PCI?
Cohort (n=253)
No
Does a multidisciplinary cardiac rehabilitation program improve exercise capacity in older patients discharged after ACS treated with PCI?
Odds Ratio: 1.18 (95% CI 1.09–1.28)
p-value: p=<0.001
A 4-week multidisciplinary cardiac rehabilitation program significantly improves exercise capacity in very old patients (≥75 years) early after discharge for ACS treated with PCI.
CR-associated exercise capacity gains in very old post-ACS patients warrant caution; leaves open need for RCTs on functional and clinical outcomes.
Background The positive effect of cardiac rehabilitation (CR) on outcomes after acute coronary syndromes (ACS) is established. Nevertheless, enrollment rates into CR programs remain low, although ACS carry a high risk of functional decline particularly in the elderly. Aim We aimed to determine if a multidisciplinary CR improves exercise capacity in an older population discharged after ACS systematically treated with PCI. Methods CR-AGE ACS is a prospective, single-center, cohort study. All patients aged 75+ years consecutively referred to Cardiac Rehabilitation outpatient Unit at Careggi University Hospital, were screened for eligibility. Moderate/severe cognitive impairment, disability in 2+ basic activities of daily living, musculoskeletal diseases, contraindication to Cardiopulmonary Exercise Test, and diseases with an expected survival < 6 months, were exclusion criteria. Participants attended a CR program, based on 5-day-per-week aerobic training sessions for 4 weeks. Results We enrolled 253 post-ACS patients with a mean age 80.6 ± 4.4 years. After CR, 136 (56.2%) 77 (31.3%) patients obtained, respectively, at least a moderate (∆+5%) or an optimal (∆+15%) increase in VO 2 peak. Baseline VO 2 peak (− 1 ml/kg/min: OR 1.18; 95% CI 1.09–1.28), the number of training sessions (+1 session: OR 1.07; 95% CI 1.01–1.15), and mild-to-moderate baseline disability (yes vs. no: OR 0.22; 95% CI 0.01–0.57) were the predictors of VO 2 peak changes. Conclusions A CR program started early after discharge from ACS produces a significant increase in exercise capacity in very old patients with mild-to-moderate post-acute physical impairment. Baseline VO 2 peak, the number of training sessions, and the level of baseline disability are the independent predictors of improvement.
No takes yet. Share an insight, caveat, or question.
Baldasseroni et al. (2022) conducted a cohort in Acute coronary syndrome (ACS) treated with PCI (n=253). Lower baseline VO2peak (per 1 ml/kg/min decrease) vs. Higher baseline VO2peak was evaluated on Moderate increase in VO2peak (>+5% from baseline) (OR 1.18, 95% CI 1.09-1.28, p=<0.001). A 1 ml/kg/min lower baseline VO2peak independently predicted an increased probability of achieving a moderate improvement in exercise capacity (OR 1.18) following a 4-week cardiac rehabilitation program in older adults post-ACS.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: