Dose of Cardiac Rehabilitation to Reduce Mortality and Morbidity: A Population-Based Study
The result's identifiers
Result code in IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00159816%3A_____%2F21%3A00075058" target="_blank" >RIV/00159816:_____/21:00075058 - isvavai.cz</a>
Result on the web
<a href="https://www.ahajournals.org/doi/epub/10.1161/JAHA.120.021356" target="_blank" >https://www.ahajournals.org/doi/epub/10.1161/JAHA.120.021356</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.1161/JAHA.120.021356" target="_blank" >10.1161/JAHA.120.021356</a>
Alternative languages
Result language
angličtina
Original language name
Dose of Cardiac Rehabilitation to Reduce Mortality and Morbidity: A Population-Based Study
Original language description
Background There is wide variability in cardiac rehabilitation (CR) dose (ie, number of sessions) delivered, and no evidence-based recommendations regarding what dose to prescribe. We aimed to test what CR dose impacts major adverse cardiovascular events (MACEs). Methods and Results This is an historical cohort study of all patients who had coronary artery disease and who initiated supervised CR between 2002 and 2012 from a single major CR center. CR dose was defined as number of visits including exercise and patient education. Follow-up was performed using record linkage from the Rochester Epidemiology Project. MACEs included acute myocardial infarction, unstable angina, ventricular arrhythmias, stroke, revascularization, or all-cause mortality. Dose was analyzed in several ways, including tertiles, categories, and as a continuous variable. Cox models were adjusted for factors associated with dose and MACE. The cohort consisted of 2345 patients, who attended a mean of 12.5 +/- 11.1 of 36 prescribed sessions. After a mean follow-up of 6 years, 695 (29.65%) patients had a MACE, including 231 who died. CR dose was inversely associated with MACE (hazard ratio, 0.66 [95% CI]; 0.55-0.91) in those completing >= 20 sessions, when compared with those not exposed to formal exercise sessions (<= 1 session; log-rank P=0.007). We did not find evidence of nonlinearity (P >= 0.050), suggesting no minimal threshold nor ceiling. Each additional session was associated with a lower rate of MACE (fully adjusted hazard ratio, 0.98 [95% CI, 0.97-0.99]). Greater session frequency was also associated with lower MACE risk (fully adjusted hazard ratio, 0.74 [95% CI, 0.58-0.94]). Conclusions CR reduces MACEs, but the benefit appears to be linear, with greater risk reduction with higher doses, and no upper threshold.
Czech name
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Czech description
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Classification
Type
J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database
CEP classification
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OECD FORD branch
30201 - Cardiac and Cardiovascular systems
Result continuities
Project
Result was created during the realization of more than one project. More information in the Projects tab.
Continuities
P - Projekt vyzkumu a vyvoje financovany z verejnych zdroju (s odkazem do CEP)
Others
Publication year
2021
Confidentiality
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů
Data specific for result type
Name of the periodical
JOURNAL OF THE AMERICAN HEART ASSOCIATION
ISSN
2047-9980
e-ISSN
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Volume of the periodical
10
Issue of the periodical within the volume
20
Country of publishing house
US - UNITED STATES
Number of pages
14
Pages from-to
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UT code for WoS article
000708514100005
EID of the result in the Scopus database
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