Exercise capacity improvement after cardiac rehabilitation following myocardial infarction and its association with long-term cardiovascular events

Author:

Novaković Marko1,Novak Tjaša2,Vižintin Cuderman Tjaša1,Krevel Barbara1,Tasič Jerneja1,Rajkovič Uroš3,Fras Zlatko12,Jug Borut12

Affiliation:

1. Department of Vascular Diseases, Centre for Preventive Cardiology, University Medical Centre Ljubljana, Zaloška cesta 7/VI, Ljubljana SI-1000, Slovenia

2. Faculty of Medicine, University of Ljubljana, Vrazov trg 2, Ljubljana SI-1000, Slovenia

3. Faculty of Organizational Sciences, University of Maribor, Kidričeva cesta 55a, Kranj SI-4000, Slovenia

Abstract

Abstract Aims  Cardiovascular rehabilitation (CR) improves aerobic capacity and quality of life in patients after myocardial infarction (MI). The aim was to examine the associations between exercise capacity improvement and different clinically relevant cardiovascular events. Methods and results  This was a registry-based study of post-MI patients, referred to CR. All patients were submitted to exercise testing before and after CR (36 sessions, 2–3 times/week, and combined exercise). Patients were divided into two groups, based on the difference in exercise capacity before and after the CR programme with the cut-off of two metabolic equivalents (METs) improvement. We assessed the correlation between the extent of exercise capacity improvement and the following cardiovascular events: major adverse cardiac events (MACE), cardiovascular-related hospitalizations, and unplanned coronary angiography. A total of 499 patients were included (mean age 56 ± 10 years, 20% women). Both groups significantly improved in terms of exercise capacity, natriuretic peptide levels, resting heart rate, and resting diastolic pressure; however, lipid status significantly improved only in patients with ≥2 METs difference in exercise capacity. A total of 13.4% patients suffered MACE (median follow-up 858 days); 21.8% were hospitalized for cardiovascular reasons (median follow-up 791 days); and 19.8% had at least one unplanned coronary angiography (median follow-up 791 days). Exercise capacity improvement of ≥2 METs was associated with lower rates of MACE, cardiovascular hospitalizations, and unplanned coronary angiography in all examined univariate and multivariate models. Conclusion  This study has shown that exercise improvement of ≥2 METs is associated with a significant decrease in MACE, cardiac hospitalizations, and unplanned coronary angiography.

Publisher

Oxford University Press (OUP)

Subject

Advanced and Specialized Nursing,Medical–Surgical Nursing,Cardiology and Cardiovascular Medicine

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