Key result
Older age (≥65 years) was associated with significantly smaller improvements in peak oxygen uptake after cardiac rehabilitation compared to younger patients (0.79 vs 1.60 mL/kg/min; p=0.016).
Why the study?
Older individuals have a worse prognosis after acute myocardial infarction, but the impact of age on the functional benefits of an exercise-based cardiac rehabilitation program remained to be assessed.
Does an exercise-based cardiac rehabilitation program improve functional parameters differently in elderly versus non-elderly myocardial infarction survivors?
Cohort (n=379)
Does an exercise-based cardiac rehabilitation program improve functional parameters differently in elderly versus non-elderly myocardial infarction survivors?
While elderly myocardial infarction survivors derive significant functional benefits from cardiac rehabilitation, their improvements in peak oxygen uptake and exercise duration are smaller compared to younger patients.
Functional benefits of EBCR post-AMI may vary by age; leaves open whether older survivors derive comparable gains.
Background: Exercise-based cardiac rehabilitation (EBCR) plays a pivotal role in the management of acute myocardial infarction (AMI). Studies have shown that older individuals have a worse prognosis after an AMI, attesting to the importance of risk reduction strategies. We aimed at assessing the impact of age (patients dichotomized as ≥65 years old or <65 years old) on the functional benefits of an EBCR program among AMI survivors. Design: Observational, retrospective cohort study. Participants: All patients admitted due to an AMI who completed a phase II EBCR program after discharge, between November 2012 and April 2017. Intervention: EBCR program. Measurements: Functional parameters were assessed by a symptom-limited cardiopulmonary exercise test. Results: A total of 379 patients were included (30% aged ≥65 years). After the EBCR program, peak oxygen uptake (pVO₂) and exercise duration increased significantly. Patients aged ≥65 years presented with more comorbidities and a lower functional capacity. Those aged ≥65 years presented significantly smaller improvements in pVO₂ (0.79 ± 2.61 vs. 1.60 ± 3.11 mL/kg/min, p = 0.016) and exercise duration [75 (59–120) vs. 120 s (60–180), p = 0.002]. This was maintained after adjusting for several potential confounders. Conclusion: Older patients have a worse functional capacity than their younger counterparts. Still, a contemporary EBCR program was associated with significant functional improvements among those aged ≥65 years. The smaller improvements even after adjustments for potential confounders suggest that physiological differences may contribute to this finding. These results highlight the relevance of EBCR among this higher-risk subgroup.
No takes yet. Share an insight, caveat, or question.
Vilela et al. (2019) conducted a cohort in Acute myocardial infarction (n=379). Age ≥65 years vs. Age <65 years was evaluated on Improvement in peak oxygen uptake (pVO2) (p=0.016). Older age (≥65 years) was associated with significantly smaller improvements in peak oxygen uptake after cardiac rehabilitation compared to younger patients (0.79 vs 1.60 mL/kg/min; p=0.016).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: