Abstract 18183: Cardiac Rehabilitation is Associated with Reduced Mortality and Hospitalization in Subjects with Congestive Heart Failure
Introduction: While Cardiac Rehabilitation (CR) is associated with improved survival and QOL in subjects with coronary artery disease, its role in patients with congestive heart failure (CHF) has been called into question. The objective of this study was to assess the association between CR attendance and mortality and hospitalization in subjects with CHF.
Methods: All subjects who were referred to CR in Calgary, Canada between 1996 and 2010 and had a concomitant diagnosis of CHF were included in this analysis. Baseline patient characteristics including age, sex, and clinical characteristics were compared between those who completed CR and did not. Cox proportional hazard models were constructed to assess the association between CR completion and each of mortality, hospitalization, cardiac hospitalization, and CHF hospitalization. A propensity model was then constructed to predict attendance, and non-attendees were matched to attendees; hazard models were then re-run.
Results: A total of 1300 subjects with CHF were referred to CR; those who completed CR (n=620) were younger (mean age 61.5 vs 63.8 years, p<0.0001) and more likely to be male (74.4 vs 61.7%, p<0.0001). There were 298 deaths in the follow-up period, 190 of which occurred in the non-CR group. CR completion was associated with reduced mortality (HR 0.55, 95% CI 0.43, 0.70), reduced hospitalization (HR 0.70, 95%CI 0.59, 0.83), reduced cardiac hospitalizations, and reduced CHF-specific hospitalizations. Of the CR completers, 529 (81.3%) matched to non-completers. In the propensity matched subgroup, CR completion remained associated with decreased mortality, hospitalizations, cardiac hospitalizations, and CHF hospitalizations.
Conclusions: Using a tightly controlled propensity matched analysis in a well characterized group of patients, we found that CR attendance is associated with reduced mortality and hospitalization in CHF patients. Therefore, contrary to more recent analyses, our results indicate CR is an integral component of care in the CHF population.
- © 2012 by American Heart Association, Inc.