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April 25, 2019Journal of Cardiopulmonary Rehabilitation and Prevention15 citations

Referral to Cardiac Rehabilitation and Outcomes for Patients With Takotsubo Cardiomyopathy

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CWCarolyn M. WuJMJohn McKeonJAJ. Dawn Abbott

Key Result

Cardiac rehabilitation completion in patients with Takotsubo cardiomyopathy was associated with a 0% 1-year cardiac readmission rate versus 13% in non-completers (P=0.47).

Study Design

Type

Cohort (n=380)

Multicenter

Yes

Structured PICO

Does cardiac rehabilitation improve exercise capacity and clinical outcomes in patients with Takotsubo cardiomyopathy?

P
Population
380 patients who survived an index hospitalization for Takotsubo cardiomyopathy.
E
Exposure
Cardiac rehabilitation program (patients who completed attended 33 ± 6 sessions).
C
Comparator
Patients referred but who did not attend or complete cardiac rehabilitation (for readmission outcome).
O
Outcome
Participation rates and outcomes (weight, body mass index, exercise duration, and 1-year cardiac readmission).

Referral to cardiac rehabilitation for Takotsubo cardiomyopathy is very low, but participation may improve exercise capacity and promote weight loss.

Main Result

Absolute Event Rate: 0% vs 13%

p-value: p=.47

Limitations

  • Limited data

Abstract

PURPOSE: The aim of this study was to determine participation rates and outcomes for patients with Takotsubo cardiomyopathy (TC) in a cardiac rehabilitation (CR) program. METHODS: Patients at 2 academic medical centers with a discharge diagnosis of TC from January 2008 to March 2015 were retrospectively identified. Patients meeting the Mayo Clinic criteria for TC were cross-matched to the CR center affiliated with the hospitals to determine the referral rate and outcomes after completion of the program. RESULTS: In total, 380 unique patients were identified who survived the index hospitalization. Eighteen patients (5%) were referred to CR, 15 enrolled, and of those enrolled, 10 patients (67%) completed the program. Patients undergoing percutaneous coronary intervention of a nonculprit vessel at the time of diagnosis was the only predictor for referral to CR (11% vs 1%, P = .01). The 10 patients who completed CR attended 33 ± 6 (range, 20-36) sessions. Weight and body mass index reduction were 2.8 ± 3.5 lb and 0.6 ± 0.7 kg/m (P = .04, both), respectively. Post-CR exercise duration was 37 ± 4 min/session, which improved by 13 ± 6 min/session from baseline (P < .01). Two patients entered the phase III maintenance program. One-year cardiac readmission rates were comparable among patients who completed CR and those who were referred but did not attend or complete CR (0% vs 13%, P = .47). CONCLUSIONS: Referral for the TC population was low; however, enrollment and completion rates were adequate, with percutaneous coronary intervention in nonculprit vessel as the only predictor of CR referral. Limited data showed CR may help with weight reduction and improve exercise duration.

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Cite This Study

Wu et al. (2019) conducted a cohort in Takotsubo cardiomyopathy (n=380). Cardiac rehabilitation vs. Referred but did not attend or complete cardiac rehabilitation was evaluated on One-year cardiac readmission (p=.47). Cardiac rehabilitation completion in patients with Takotsubo cardiomyopathy was associated with a 0% 1-year cardiac readmission rate versus 13% in non-completers (P=0.47).

synapsesocial.com/papers/6a9b569d9b6f41daef88293ahttps://doi.org/10.1097/hcr.0000000000000433
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