Attendance at cardiac rehabilitation is associated with lower all-cause mortality after 14 years of follow-up

Abstract

Objective To investigate whether attendance at cardiac rehabilitation (CR) independently predicts all-cause mortality over 14 years and whether there is a doseresponse relationship between the proportion of CR sessions attended and long-term mortality. Design Retrospective cohort study. Setting CR programmes in Victoria, Australia Patients The sample comprised 544 men and women eligible for CR following myocardial infarction, coronary artery bypass surgery or percutaneous interventions. Participants were tracked 4 months after hospital discharge to ascertain CR attendance status. Main outcome measures All-cause mortality at 14 years ascertained through linkage to the Australian National Death Index. Results In total, 281 (52%) men and women attended at least one CR session. There were few significant differences between non-attenders and attenders. After adjustment for age, sex, diagnosis, employment, diabetes and family history, the mortality risk for nonattenders was 58% greater than for attenders (HR=1.58, 95% CI 1.16 to 2.15). Participants who attended <25% of sessions had a mortality risk more than twice that of participants attending ≥75% of sessions (OR=2.57, 95% CI 1.04 to 6.38). This association was attenuated after adjusting for current smoking (OR=2.06, 95% CI 0.80 to 5.29). Conclusions This study provides further evidence for the long-term benefits of CR in a contemporary, heterogeneous population. While a dose-response relationship may exist between the number of sessions attended and long-term mortality, this relationship does not occur independently of smoking differences. CR practitioners should encourage smokers to attend CR and provide support for smoking cessation. BACKGROUND

Utility of Regular Management of Physical Activity and Physical Function in Hemodialysis Patients

“…3). In cardiovascular patients, it is clear that attending a higher proportion of cardiovascular rehabilitation sessions confers greater longterm benefit than attending fewer sessions [43][44][45]. Our findings were consistent with those of previous studies in cardiovascular patients.…”

“…On the other hand, some other studies regarding prevention, e.g., in the general sedentary population, [40] patients with cancer, [41,42] and cardiovascular disease patients, [43][44][45] used the proportion of exerciserelated program attendance as a predictor of outcome. In the present study, the median proportion of attendance at the management program was 75%, which was within the range reported in other studies [41,42,45] (Fig.…”

High-intensity interval training in patients with coronary heart disease: Prescription models and perspectives

“…Therefore, cardiac rehabilitation programs with an exercise training component such as continuous aerobic exercise training (CAET) were found to be safe and to improve prognosis in CHD patients [7][8][9][10][11]. The additional clinical benefits of exercise training in CHD patients are well documented and include improvements in cardiovascular, lung and skeletal muscle functions, endurance, quality of life, inflammation, depressive symptoms, stress and cognitive functions [12,13].…”

40years of cardiac rehabilitation and secondary prevention in post-cardiac ischaemic patients. Are we still in the wilderness?

“…These studies have shown that only 20-40% of candidates actually attend cardiac rehabilitation programmes. The non-attenders have about a 30% worse survival than do attenders, a much worse survival than seen in the control groups of randomised controlled studies [69][70][71][72][73][74][75][76][77]. Furthermore, the reduction in mortality was more marked than any reduction in cardiac deaths, cardiac morbidity or cardiac interventions.…”