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Eur J Prev Cardiol ; 27(8): 811-819, 2020 05.
Article in English | MEDLINE | ID: mdl-31744334

ABSTRACT

BACKGROUND: Improvement in exercise capacity is a main goal of cardiac rehabilitation but the effects are often lost at long-term follow-up and thus also the benefits on prognosis. We assessed whether improvement in VO2peak during a cardiac rehabilitation programme predicts long-term prognosis. METHODS AND RESULTS: We performed a retrospective analysis of 1561 cardiac patients completing cardiac rehabilitation in 2011-2017 in Copenhagen. Mean age was 63.6 (11) years, 74% were male and 84% had coronary artery disease, 6% chronic heart failure and 10% heart valve replacement. The association between baseline VO2peak and improvement after cardiac rehabilitation and being readmitted for cardiovascular disease and/or all-cause mortality was assessed with three different analyses: Cox regression for the combined outcome, for all-cause mortality and a multi-state model. During a median follow-up of 2.3 years, 167 readmissions for cardiovascular disease and 77 deaths occurred. In adjusted Cox regression there was a non-linear decreasing risk of the combined outcome with higher baseline VO2peak and with improvement of VO2peak after cardiac rehabilitation. A similar linear association was seen for all-cause mortality. Applying the multi-state model, baseline VO2peak and change in VO2peak were associated with risk of a cardiovascular disease readmission and with all-cause mortality but not with mortality in those having an intermediate readmission for cardiovascular disease. CONCLUSION: VO2peak as well as change in VO2peak were highly predictive of future risk of readmissions for cardiovascular disease and all-cause mortality. The predictive value did not extend beyond the next admission for a cardiovascular event.


Subject(s)
Cardiac Rehabilitation/mortality , Coronary Disease/therapy , Exercise Tolerance , Oxygen Consumption , Patient Readmission , Secondary Prevention , Aged , Aged, 80 and over , Cardiac Rehabilitation/adverse effects , Coronary Disease/diagnosis , Coronary Disease/mortality , Coronary Disease/physiopathology , Denmark/epidemiology , Female , Humans , Male , Middle Aged , Recovery of Function , Retrospective Studies , Risk Assessment , Risk Factors , Time Factors , Treatment Outcome
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