Participation in structured cardiac rehabilitation after an acute cardiovascular event was associated with significantly lower LDL cholesterol (49.6 vs 69.9 mg/dl, p<0.001) at 12 months.
Case-Control (n=114)
Does a structured cardiac rehabilitation program improve metabolic and hemodynamic outcomes in patients after an acute cardiovascular disease?
Participation in structured cardiac rehabilitation significantly improves long-term metabolic control, blood pressure, and adherence to evidence-based therapies in patients following acute cardiovascular events.
Absolute Event Rate: 49.6% vs 69.9%
p-value: p=<0.001
Objective: Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality worldwide. Cardiac rehabilitation (CR) is a cornerstone of secondary prevention after ischemic events, but adherence and access to structured programs remain suboptimal. This retrospective case–control study aimed to evaluate the clinical, metabolic and therapeutic effects of a structured CR program in patients after an acute CVD, in comparison to usual care. Design and method: Sixty patients who completed CR program after an acute CVD, were compared with fifty-four patients with comparable clinical characteristics who did not undergo CR. Clinical, hemodynamic, and biochemical parameters were analysed during hospitalization, at the time of CR and after 6 months only among those who participated in CR, and after 12 months in the overall group. Results: We examined 114 patients, mean age 60.8 ± 8.6 years, BMI 28.1 ± 4.7 kg/m2, 85.1% males. Clinical presentation at enrolment was: 67.5% STEMI/NSTEMI treated with PCI, 13.2% aortocoronary bypass surgery, 12.3% stable angina, and 7.0% unstable angina. No statistically significant difference was observed for prevalence of smoking habit, diabetes mellitus, arterial hypertension, dyslipidaemias, pharmacological treatment prescribed and baseline metabolic data between CR and control group (p > 0.05 for all). At 6 months, the CR group showed significant improvements of body mass index (-0.52 kg/m2, p=0.007), LDL cholesterol (-17.9 mg/dL, p=0.003), and heart rate (-3.9 bpm, p=0.001). After 12 months, patients who underwent CR maintained better LDL (49.6 ± 16.5 vs 69.9 ± 23.6 mg/dl, p<0.001) and glycaemic control (HbA1c 5.88 ± 0.29 vs 6.76 ± 0.72%, p<0.001) and lower blood pressure (124.9 ± 8.6/74.2 ± 7.6 vs 135.1 ± 15.6/80.4 ± 9.4 mmHg, p=0.001/0.003) compared with controls. Greater adherence to pharmacological therapy, particularly to ezetimibe and PCSK9 inhibitors, was also observed. Moreover, those engaged into CR maintained a greater adherence to physical activity program (63.3% performed moderate to intensity physical activity, vs 31,5%, p=0.011). Conclusions: Participation in structured CR is associated with improved metabolic and hemodynamic outcomes, as well as higher adherence to evidence-based therapies. CR remains an essential component of comprehensive secondary prevention for ischemic heart diseases.
Saladini et al. (Fri,) conducted a case-control in Acute cardiovascular disease (n=114). Structured cardiac rehabilitation program vs. Usual care (no cardiac rehabilitation) was evaluated on LDL cholesterol at 12 months (mg/dL) (p=<0.001). Participation in structured cardiac rehabilitation after an acute cardiovascular event was associated with significantly lower LDL cholesterol (49.6 vs 69.9 mg/dl, p<0.001) at 12 months.