Dose of Cardiac Rehabilitation to Reduce Mortality and Morbidity: A Population-Based Study

Kód výsledku v 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>

Výsledek na webu

<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>

Jazyk výsledku

angličtina

Název v původním jazyce

Dose of Cardiac Rehabilitation to Reduce Mortality and Morbidity: A Population-Based Study

Popis výsledku v původním jazyce

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 &gt;= 20 sessions, when compared with those not exposed to formal exercise sessions (&lt;= 1 session; log-rank P=0.007). We did not find evidence of nonlinearity (P &gt;= 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.

Název v anglickém jazyce

Dose of Cardiac Rehabilitation to Reduce Mortality and Morbidity: A Population-Based Study

Popis výsledku anglicky

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 &gt;= 20 sessions, when compared with those not exposed to formal exercise sessions (&lt;= 1 session; log-rank P=0.007). We did not find evidence of nonlinearity (P &gt;= 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.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

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OECD FORD obor

30201 - Cardiac and Cardiovascular systems

Projekt

Výsledek vznikl pri realizaci vícero projektů. Více informací v záložce Projekty.

Návaznosti

P - Projekt vyzkumu a vyvoje financovany z verejnych zdroju (s odkazem do CEP)

Rok uplatnění

2021

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

JOURNAL OF THE AMERICAN HEART ASSOCIATION

ISSN

2047-9980

e-ISSN

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Svazek periodika

10

Číslo periodika v rámci svazku

20

Stát vydavatele periodika

US - Spojené státy americké

Počet stran výsledku

14

Strana od-do

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Kód UT WoS článku

000708514100005

EID výsledku v databázi Scopus

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