Abstract 16827: A Cardiac Rehabilitation Improves the Risk of the MACE of Post Abdominal Aortic Aneurysm Repair
Background: Cardiac rehabilitation in patients with ischemic disease improves the quality of life and reduces the mortality. Meanwhile, though there is a high prevalence of coexistence of ischemic disease in patients with an abdominal aortic aneurysm (AAA), the influence of cardiac rehabilitation after AAA repair are still unknown. This is the first report on the beneficial effects of the cardiac rehabilitation on prognosis after AAA surgery.
Methods: We conducted an observed cohort study on 1053 patients receiving surgical repair of AAA in the multicenter in Tokyo from January 2003 to December 2011. The patients who had cardiac rehabilitation more than once a week for more than 3 months after surgery were classified into rehabilitation group. Kaplan-Meier survival analyses and Cox hazards model were performed to compare the risk of death and the risk of major adverse cardiac events (MACE; composite of cardiovascular death without postoperative in-hospital death, acute coronary syndrome, cerebrovascular disorder) between the rehabilitation group and non-rehabilitation group. The patients in rehabilitation group underwent cardiopulmonary exercise testing (CPX) before and 3 months after surgery.
Results: The average follow-up period was 2.5±2.1 years. The 335 patients had cardiac rehabilitation after AAA repair, and the other 718 patients did not. Basal characteristics including age, gender, hypertension, dyslipidemia, diabetes, smoking and drugs were statistically similar in both groups. Peak VO2/kg, AT/kg and ΔVO2/ΔWR were improved in rehabilitation group. The survival rate wasn’t different between rehabilitation group and non-rehabilitation group, but the risk of MACE after surgery was lower in rehabilitation group compared with non-rehabilitation group (OR 0.48, CI 0.25-0.97, p=0.040). Particularly, in patients with surgical repair for ruptured AAA (n=183), a higher survival rate was observed in rehabilitation group compared with non-rehabilitation group.
Conclusions: Cardiac rehabilitation in patients after AAA surgery improved the risk of MACE, and especially in patients receiving surgical repair for ruptured AAA, cardiac rehabilitation improved the survival rate after surgery.
- © 2013 by American Heart Association, Inc.