Abstract 10239: Predictors of Survival After Coronary Artery Bypass Graft in Young and Elderly Patients After Cardiac Rehabilitation
Whether the increase in distance walked after cardiovascular rehabilitation (CR) translates into improved survival in patients after coronary artery bypass graft (CABG) is still debated. The aim of the study was to investigate the prognostic value on survival of distance walked in 6 min (6MWT), ejection fraction (EF), change in distance walked between admission and discharge in 6 min (Δ 6MWT) in CABG) patients admitted to CR evaluating difference between young and elderly patients (< 65 and ≥ 65 years). 6MWT is used to assess the response to therapeutic interventions in CR. Here, we studied 882 patients consecutively enrolled from October 2004 to April 2008 who were referred to our institution soon after CABG. A standardized color-doppler echocardiography and 6MWT was performed at baseline and at discharge. All patients were followed up since April 2010. Mean age of the 882 patients was 63.8±8.9 years (range 34–84), 48.9% with age ≥ 65 years. Mean EF was 52.1±8.9, mean 6MWT was 303.7±103.4 and mean Δ 6MWT was 90.7±68.5. 83 patients (9.4%) died after a mean follow-up of 42.7 months. Cox regression analysis demonstrate that EF (HR= 0.952; 95% CI = 0.920–0.985; p=0.005) and 6MWT (HR = 0.997; 95% CI =0.993–0.999; p=0.046) were predictive of mortality independently by the effect of age and Δ 6MWT. When patients were divided into two subgroups according to age (< 65 and ≥ 65 years), EF was predictive in the group of patients with age < 65 years (HR = 0.911; 95% CI =0.864–0.960; p=0.001) while distance walked at baseline was predictive of mortality in patients with age ≥ 65 years (HR = 0.994; 95% CI =0.988–0.999; p=0.040) (Table 1). Our Results establish that EF and 6MWT are independent prognostic information in CABG patients. Different results are observed between young and elderly patients where 6MWT, and no EF, predicts survival.
- © 2010 by American Heart Association, Inc.