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

Abstract

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.

Power walking based outpatient cardiac rehabilitation in patients with post‐coronary angioplasty: Randomized control trial

“…Kasperowicz et al. (2019) showed that an improvement in exercise capacity with 75.4 m and 1 MET in 6MWT and exercise stress test respectively was significant.…”

“…The 6‐min walk test (6MWT) was a reliable and valid tool used to determine exercise capacity and prescribe exercise intensity in patients undergone CR after coronary angioplasty (Kasperowicz et al., 2019; Bellet et al., 2012). Participants walked hospital corridor 44 m in length in 6 min and meters covered was recorded.…”

Benefits of cardiac rehabilitation following acute coronary syndrome for patients with and without diabetes: a systematic review and meta-analysis

“…ACS patients with type 2 diabetes were exclusively included in 11 studies [ 31 , 34 – 36 , 38 , 39 , 41 – 44 , 46 ]. Four studies included ACS patients with type 1 or type 2 diabetes [ 29 , 32 , 40 , 47 ], and five studies did not account for the type of diabetes [ 28 , 30 , 33 , 37 , 45 ]. A diagnosis of diabetes was classified from a fasting blood glucose test or from hospital records in 11 of the studies [ 34 – 38 , 40 – 42 , 44 , 46 , 47 ].…”

“…A diagnosis of diabetes was classified from a fasting blood glucose test or from hospital records in 11 of the studies [ 34 – 38 , 40 – 42 , 44 , 46 , 47 ]. In seven studies, diabetes was classified from a self-reported history, taking diabetes medication, or a lack of information on classification [ 28 , 31 – 33 , 39 , 43 , 45 ]. Additional file 4 presents specific classification procedures.…”

“…Encouraged to exercise on non CR days (f) Exercise, two class room teachings on heart healthy diet. Behavioral weight loss sessions advised for patients being overweight (g) Not reported (h) 5 (a) 22.6% (b) 64.1 ± 10.9* (c) 32.6%* (d) METs: 6.6 ± 2.4 Peak VO 2 mLO/kg/min: 17.3 ± 5.8* (e) 67.0% completed the program (f) Type 2 only (g) Not reported (a) 33.7%, (no insulin resistance group formed the comparison group) (b) 62.5 ± 10.8 (c) 21.5% (d) METs: 7.9 ± 2.9 Peak VO 2 mLO/kg/min: 21.8 ± 6.8 (e) 60.8% completed the program (a) Exercise capacity ± SD; mean change ± SD at three to four-month follow-up (b) ACS patients with diabetes 7.5 ± 2.7 METs; 20.2 ± 5.5 Peak Vo2; + 1.3 ± 2.3 ACS patients without diabetes 10.2 ± 3.4 METs; 25.5 ± 7.8 Peak Vo2; + 2.2 ± 2.5 *No insulin resistance group formed the comparison group (without diabetes) VO2 peak converted into METs Kasperowicz [ 45 ] (2019) Poland (a) 100 (b) 2005–2015 (c) MI treated with invasive procedures (d) Hospital based (e) 12 week programme, dose not reported (f) Exercise (g) Not reported (h) 2 (a) 40% (b) 59.3 ± 7.7 (c) 35% (d) 7.2 ± 2.0 (e) not reported (f) not reported (g) not reported (a) 60% (b) 57.6 ± 7.8 (c) 40% (d) 7.2 ± 2.0 (e) not reported (a) Exercise capacity ± SD; mean change at three-week follow-up (b) ACS patients with diabetes 7.7 ± 2.2; + 0.5 ACS patients without diabetes 8.4 ± 1.7; + 1.2 Laddu (2020) [ 46 ] Canada (a) n = 3953 (analysed patients were propensity matched from entire population) (b) January 1996- March 2016 (c) Cardiac catheterization and/or revascularization (d) Hospital based (e) 12-week programme, 60 min × 2 /week (f) Exercise and individualized education. Support with risk factor management, and access to a multidisciplinary team of healthcare providers (g) Measurement of blood glucose at exercise sessions for DM patients (h) 4 (a) 18.7% (b) 62.6 ± 9.4 (c) 19% (d) 6.7 ± 1.9 METs (e) not reported (f) Type 2 only (g) not reported (a) 81.3% (b) 62.7 ± 10.7 (c) 20% (d) 7.2 ± 2.1 METs (e) not reported (a) Exercise capacity mean change ± SD at 12-week follow-up (b) ACS patients with diabetes 0.9 ± 0.9 (13.0%) ACS patients without diabetes ...…”