Compared to PCI, exercise-based cardiac rehabilitation was associated with significantly lower odds of 18-month all-cause mortality (OR 0.37; 95% CI 0.29-0.47) in patients with chronic coronary syndrome.
Cohort (n=18,383)
Yes
Does exercise-based cardiac rehabilitation reduce 18-month mortality and morbidity compared to percutaneous coronary intervention in patients with chronic coronary syndrome?
Exercise-based cardiac rehabilitation is associated with lower 18-month mortality and morbidity compared to PCI in patients with chronic coronary syndrome.
Odds Ratio: 0.37 (95% CI 0.29–0.47)
AIMS: Accumulating evidence questions the clinical value of percutaneous coronary intervention (PCI) for patients with chronic coronary syndrome (CCS). We therefore compare the impact of exercise-based cardiac rehabilitation (CR) vs. PCI in patients with CCS on 18-month mortality and morbidity, and evaluate the effects of combining PCI with exercise-based CR. METHODS AND RESULTS: A retrospective cohort study was conducted in March 2021. An online, real-world dataset of CCS patients was acquired, utilizing TriNetX, a global federated health research network. Patients with CCS who received PCI were first compared with patients who were prescribed exercise-based CR. Second, we compared patients who received both CR + PCI vs. CR alone. For both comparisons, patients were propensity-score matched by age, sex, race, comorbidities, medications, and procedures. We ascertained 18-month incidence of all-cause mortality, rehospitalization, and cardiovascular comorbidity stroke, acute myocardial infarction (AMI), and new-onset heart failure. The initial cohort consisted of 18 383 CCS patients. Following propensity score matching, exercise-based CR was associated with significantly lower odds of all-cause mortality 0.37 (95% confidence interval (CI): 0.29-0.47), rehospitalization 0.29 (95% CI: 0.27-0.32), and cardiovascular morbidities, compared to PCI. Subsequently, patients that received both CR + PCI did not have significantly different odds for all-cause mortality 1.00 (95% CI: 0.63-1.60), rehospitalization 1.00 (95% CI: 0.82-1.23), AMI 1.11 (95% CI: 0.68-1.81), and stroke 0.71 (95% CI: 0.39-1.31), compared to CR only. CONCLUSIONS: Compared to PCI, exercise-based CR associated with significantly lower odds of 18-month all-cause mortality, rehospitalization, and cardiovascular morbidity in patients with CCS, whilst combining PCI and exercise-based CR associated with lower incident heart failure only.
Buckley et al. (Fri,) conducted a cohort in Chronic coronary syndrome (CCS) (n=18,383). Exercise-based cardiac rehabilitation vs. Percutaneous coronary intervention (PCI) was evaluated on 18-month all-cause mortality (OR 0.37, 95% CI 0.29-0.47). Compared to PCI, exercise-based cardiac rehabilitation was associated with significantly lower odds of 18-month all-cause mortality (OR 0.37; 95% CI 0.29-0.47) in patients with chronic coronary syndrome.