Comparison of the Effects of Cardiac Rehabilitation Between Obese and Non-obese Patients After Acute Myocardial Infarction

Lim, Seung-Kyu; Han, Jae‐Young; Choe, Yu-Ri

doi:10.5535/arm.2016.40.5.924

Cited by 10 publications

(12 citation statements)

References 28 publications

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“…With regards to weight, after adjusting for confounders our study showed that both obese and non-obese patients were equally likely to benefit from CR. A similar finding was shown by Lim et al 23 in a study of 359 CAD patients which showed that all parameters of CRF (maximal METs, exercise duration, and maximal oxygen consumption) improved significantly in obese and non-obese patients with no difference detected between the groups.…”

Section: Discussionsupporting

confidence: 88%

Predictors of cardiorespiratory fitness improvement in phase II cardiac rehabilitation

Abu‐Haniyeh

Shah

et al. 2018

Clinical Cardiology

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Background Cardiac rehabilitation (CR) improves cardiorespiratory fitness (CRF) and has been shown to reduce cardiovascular events and death. However, data about predictors of fitness improvement during CR are limited and conflicting. The objective of this study was to determine predictors of improvement in metabolic equivalents of task (METs) based on formal exercise testing throughout phase II CR. Methods We retrospectively reviewed 20 671 patients enrolled in phase II CR at our center from 2006 to 2016. Patients who completed 36 sessions and had entry and exit exercise stress tests were included for study. The short form‐36 (SF‐36) questionnaire was used to assess quality‐of‐life. Univariate and multivariate regression analyses were performed to determine independent predictors of METs improvement. Results Of the full cohort, 827 patients completed 36 sessions and had entry/exit stress test data. The majority of patients (N = 647, 78.2%) had improvement in METs (mean Δ 2.0 ± 1.2 METs), including patients ≥65 and < 65 years old (77% vs 79%, P = 0.46 for difference). METs improvement was negatively associated with body mass index, diabetes, left ventricular dysfunction, and poor baseline fitness; and positively associated with SF‐36 score (P < 0.05 for all). After multivariable adjustment, improvement was no longer affected by age, ejection fraction, or baseline fitness. Patients with poor fitness (≤5 METS) and adequate fitness (> 5 METS) both had improvement, with no statistical difference between the groups (P = 0.36). Conclusions In a large cohort of phase II CR patients, improvement in CRF was seen in the majority of patients across all ages, genders, and levels of baseline fitness.

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Section: Discussionsupporting

confidence: 88%

Predictors of cardiorespiratory fitness improvement in phase II cardiac rehabilitation

Abu‐Haniyeh

Shah

et al. 2018

Clinical Cardiology

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“…The relation of BMI and cardiac rehabilitation outcomes was analysed in two groups of patients: BMI ≥ 25 kg/m 2 ( n = 170) and BMI < 25 kg/m 2 ( n = 189). Both groups proved to have improved their capacity in the exercise test without a statistically significant difference between groups [20]. This study showed that patients with BMI ≥ 25 kg/m 2 proved their exercise capacity increase in both exercise tests whereas patients with BMI < 25 kg/m 2 achieved a statistically significant increase only in the 6-min walk test.…”

Section: Discussionmentioning

confidence: 87%

Effectiveness of Cardiac Rehabilitation in Exercise Capacity Increase in Patients with ST-Segment Elevation Myocardial Infarction

Kasperowicz

Cymerys

Kasperowicz

2019

IJERPH

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Background: The efficacy of interventions in ST-segment elevation myocardial infarction (STEMI) assessed by a decrease in inpatient mortality in Poland is very high. However, a rise in mortality rate is recorded within 3 years of the discharge from the intervention centre. In order to reduce out-of-hospital mortality, the treatment should be continued with cardiac rehabilitation after hospitalization. The aim of this retrospective study was to evaluate the effect of cardiac rehabilitation on exercise capacity increase patients with STEMI with regard to their age, gender, Body Mass Index (BMI), ejection fraction (EF), concomitant diabetes and nicotine dependence. The effectiveness of cardiac rehabilitation was assessed by exercise ECG (electrocardiogram) stress test or the 6-min walk test, prior to and after cardiac rehabilitation completion. Methods: The study group included 100 randomly selected patients undergoing cardiac rehabilitation after STEMI, aged 40–75 years, with BMI ≤ 40 kg/m2, with controlled arterial hypertension, without anemia and any pulmonary comorbidities. Results: The study patients’ exercise capacity was observed to have increased significantly (+1 metabolic equivalent (MET) in exercise ECG stress test and +75.4 m in the 6-min walk test) regardless of their gender, age, BMI and nicotine dependence. Conclusions: This study proved that every patient with STEMI could benefit from cardiac rehabilitation. Nicotine-dependents, males, patients aged ≤55 and those with reduced EF (<50%) were found to have benefitted most substantially.

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“…Contrary to this study, Lavie and Milan [18] reported equal level of post-CR improvement in obese and non-obese patients groups. In another study on the assessment of the effect of CRP on obese and non-obese patients who had acute MI, a significant increase was observed in MET values of both groups, and no superiority of the results of one group over the other could be detected [20]. Similarly, we found an equal level of functional capacity in obese and non-obese patient groups in initial assessment The values were presented as mean ± SD (standard deviation) or median (maximum-minimum).…”

Section: Discussionmentioning

confidence: 92%

“…Increasing number of obese patients increases the number of CADs [15,16]. Due to negative effects of obesity on cardiac wellbeing, it may affect the results of CR program [14,[17][18][19][20].…”

Section: Introductionmentioning

confidence: 99%

The effect of obesity on functional capacity, anxiety and daily life activities in patients with coronary artery disease and phase II cardiac rehabilitation

Aksoy

Karlıbel

Arı

et al. 2017

The European Research Journal

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Objective. The aim of our study was to investigate the effect of cardiac rehabilitation (CR) program on obese and non-obese patients with coronary artery disease. Methods. The records of 60 coronary artery disease patients aged between 18-75 years, who were included in CR were evaluated. Of the study subjects, 20 had undergone coronary artery bypass grafting (CABG) and 40 had undergone percutaneous coronary intervention (PCI). The patients were divided into two groups by body mass index (BMI), with Group I being non-obese (BMI < 30 kg/m2) and Group 2 being obese (BMI ≥ 30 kg/m2). The effect of 30 session CR on the two groups were evaluated with 6-min walk test (6MWT), Short Form-36 (SF-36) and Beck Anxiety Inventory (BAI). Results. Baseline characteristics of the group 1 (39 patients) and group 2 (21 patients) were similar. Statistically significant improvement was detected in group 1 and group 2 patients by CR program in 6MWT, BAI and SF-36 parameters (p < 0.05). 6MWT, BAI and SF-36 parameters changes by cardiac rehabilitation were compared between the two groups. According to the comparison 6MWT (group 1; 60 (20-183) vs group 2; 34 (15-180), p = 0.012) and MET (group 1; 1.44 ± 0.56 vs group 2; 1.09 ± 0.41, p = 0.015 changes were significantly higher in group 1 than in group 2. However, the changes of BAI and SF-36 parameters were similar in two groups (p > 0.05). Conclusion. CR was found to be effective and safe in terms of functional capacity, daily life activities and anxiety in both obese and non-obese patients. Functional capacity gain in the obese group was less than non-obese patients.Eur Res J 2018;4(2):85-91

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Comparison of the Effects of Cardiac Rehabilitation Between Obese and Non-obese Patients After Acute Myocardial Infarction

Cited by 10 publications

References 28 publications

Predictors of cardiorespiratory fitness improvement in phase II cardiac rehabilitation

Predictors of cardiorespiratory fitness improvement in phase II cardiac rehabilitation

Effectiveness of Cardiac Rehabilitation in Exercise Capacity Increase in Patients with ST-Segment Elevation Myocardial Infarction

The effect of obesity on functional capacity, anxiety and daily life activities in patients with coronary artery disease and phase II cardiac rehabilitation

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