Abstract 13064: The Long-term Cardiac Rehabilitation Improves the Prognosis of Patients With Cardiovascular Disease: The Large Cohort Study of Cardiac Rehabilitation in Tokyo (CART Study)
Introduction: The effects of comprehensive cardiac rehabilitation (CR) were already reported, but the most of the rehabilitation programs are consisted of short periods and the studies of continuous exercise training in a long time are not sufficient. Otherwise, many patients with cardiovascular disease clinically need sustained CR. Propose: The aim of this study is to prove the effects of the long-term CR and find the suitable candidates to be recommended participating in a rehabilitation program in the maintenance phase.
Methods: We conducted a prospective cohort study on 10,275 patients receiving CR without dropout the CR program in Sakakibara Heart Institute in Tokyo from January 2003 to August 2015. The patients who had CR in the acute phase were classified into Phase l group who needs hospitalization and the patients after acute phase who had CR more than once a week for less than 150 days were classified into Phase ll group. The patients who had CR more than once a week for more than 150 days were classified into Phase lll group. Phase ll and lll groups underwent cardiopulmonary exercise testing (CPX) at intervals of 3 months. The rate of major adverse cardiac events (MACE: composite of cardiac death, acute coronary syndrome and cerebral infarction), the rate of mortality and the result of CPX in the three groups were compared. The sub-analysis was performed on each disease which composed of stable angina pectoris, acute coronary syndrome, heart failure, post CABG, post heart valve surgery, and large vessel disease.
Results: The average age of patients was 66±14 years and the average follow-up period was 5.1±3.0 years. The patients were divided into three groups (Phase l: n=5178, Phase ll: n=3902, and Phase lll: n=1195). The average rehabilitation period of Phase lll group was 1.8±2.0 years. The risks of MACE and death were extremely lower in Phase lll group compared to that in Phase ll group, especially in patients with heart failure (MACE: HR0.59, p=0.022, and death: HR0.83, p=0.023). The improved peak VÒ2 of Phase lll group with heart failure significantly paralleled till 4.4 years by multilevel modeling.
Conclusions: The long-term cardiac rehabilitation for patients with cardiovascular disease improves the MACE, mortality and peak VÒ2.
Author Disclosures: A. Nakayama: None. M. Nagayama: None. I. Komuro: None. H. Tomoike: None.
- © 2016 by American Heart Association, Inc.