Cardiac Rehabilitation in Advanced aGE after PCI for acute coronary syndromes: predictors of exercise capacity improvement in the CR-AGE ACS study.

Abstract

BACKGROUND:

The positive effect of cardiac rehabilitation (CR) on outcomes after acute coronary syndromes (ACS) is established. Nevertheless, enrollment rates into CR programs remain low, although ACS carry a high risk of functional decline particularly in the elderly.

AIM:

We aimed to determine if a multidisciplinary CR improves exercise capacity in an older population discharged after ACS systematically treated with PCI.

METHODS:

CR-AGE ACS is a prospective, single-center, cohort study. All patients aged 75+ years consecutively referred to Cardiac Rehabilitation outpatient Unit at Careggi University Hospital, were screened for eligibility. Moderate/severe cognitive impairment, disability in 2+ basic activities of daily living, musculoskeletal diseases, contraindication to Cardiopulmonary Exercise Test, and diseases with an expected survival < 6 months, were exclusion criteria. Participants attended a CR program, based on 5-day-per-week aerobic training sessions for 4 weeks.

RESULTS:

We enrolled 253 post-ACS patients with a mean age 80.6 ± 4.4 years. After CR, 136 (56.2%) 77 (31.3%) patients obtained, respectively, at least a moderate (∆+5%) or an optimal (∆+15%) increase in VO2peak. Baseline VO2peak (- 1 ml/kg/min: OR 1.18; 95% CI 1.09-1.28), the number of training sessions (+1 session: OR 1.07; 95% CI 1.01-1.15), and mild-to-moderate baseline disability (yes vs. no: OR 0.22; 95% CI 0.01-0.57) were the predictors of VO2peak changes.

CONCLUSIONS:

A CR program started early after discharge from ACS produces a significant increase in exercise capacity in very old patients with mild-to-moderate post-acute physical impairment. Baseline VO2peak, the number of training sessions, and the level of baseline disability are the independent predictors of improvement.

• Authors: Samuele Baldasseroni, Maria Vittoria Silverii, Alessandra Pratesi, Costanza Burgisser, Francesco Orso, Giulia Lucarelli, Giada Turrin, Andrea Ungar, Niccolò Marchionni, Francesco Fattirolli
• Journal: Aging clinical and experimental research (Aging Clin Exp Res) Vol. 34 Issue 9 Pg. 2195-2203 (Sep 2022) ISSN: 1720-8319 [Electronic] Germany
• PMID: 35451734 (Publication Type: Journal Article)
• Copyright: © 2022. The Author(s).

Topics

• Activities of Daily Living
• Acute Coronary Syndrome (surgery)
• Aged
• Aged, 80 and over
• Cardiac Rehabilitation
• Cohort Studies
• Exercise Test
• Exercise Therapy
• Exercise Tolerance
• Humans
• Percutaneous Coronary Intervention
• Prospective Studies