Cardiology · 2019
Differential Impact of a Cardiac Rehabilitation Program on Functional Parameters in Elderly versus Non-Elderly Myocardial Infarction Survivors.
Сравнительное исследованиеСтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Vilela Eduardo Matos, Ladeiras Lopes Ricardo, Torres Susana, João Ana, Ribeiro Jose, Primo João, Fontes-Carvalho Ricardo, Campos Lilibeth, Miranda Fatima, Nunes José Pedro L, Teixeira Madalena, Braga Pedro
Аннотация
BACKGROUND: Exercise-based cardiac rehabilitation (EBCR) plays a pivotal role in the management of acute myocardial infarction (AMI). Studies have shown that older individuals have a worse prognosis after an AMI, attesting to the importance of risk reduction strategies. We aimed at assessing the impact of age (patients dichotomized as ≥65 years old or <65 years old) on the functional benefits of an EBCR program among AMI survivors.
DESIGN: Observational, retrospective cohort study.
PARTICIPANTS: All patients admitted due to an AMI who completed a phase II EBCR program after discharge, between November 2012 and April 2017.
INTERVENTION: EBCR program.
MEASUREMENTS: Functional parameters were assessed by a symptom-limited cardiopulmonary exercise test.
RESULTS: A total of 379 patients were included (30% aged ≥65 years). After the EBCR program, peak oxygen uptake (pVO2) and exercise duration increased significantly. Patients aged ≥65 years presented with more comorbidities and a lower functional capacity. Those aged ≥65 years presented significantly smaller improvements in pVO2 (0.79 ± 2.61 vs. 1.60 ± 3.11 mL/kg/min, p = 0.016) and exercise duration [75 (59-120) vs. 120 s (60-180), p = 0.002]. This was maintained after adjusting for several potential confounders.
CONCLUSION: Older patients have a worse functional capacity than their younger counterparts. Still, a contemporary EBCR program was associated with significant functional improvements among those aged ≥65 years. The smaller improvements even after adjustments for potential confounders suggest that physiological differences may contribute to this finding. These results highlight the relevance of EBCR among this higher-risk subgroup.
DESIGN: Observational, retrospective cohort study.
PARTICIPANTS: All patients admitted due to an AMI who completed a phase II EBCR program after discharge, between November 2012 and April 2017.
INTERVENTION: EBCR program.
MEASUREMENTS: Functional parameters were assessed by a symptom-limited cardiopulmonary exercise test.
RESULTS: A total of 379 patients were included (30% aged ≥65 years). After the EBCR program, peak oxygen uptake (pVO2) and exercise duration increased significantly. Patients aged ≥65 years presented with more comorbidities and a lower functional capacity. Those aged ≥65 years presented significantly smaller improvements in pVO2 (0.79 ± 2.61 vs. 1.60 ± 3.11 mL/kg/min, p = 0.016) and exercise duration [75 (59-120) vs. 120 s (60-180), p = 0.002]. This was maintained after adjusting for several potential confounders.
CONCLUSION: Older patients have a worse functional capacity than their younger counterparts. Still, a contemporary EBCR program was associated with significant functional improvements among those aged ≥65 years. The smaller improvements even after adjustments for potential confounders suggest that physiological differences may contribute to this finding. These results highlight the relevance of EBCR among this higher-risk subgroup.