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Effectiveness of cardiac rehabilitation in patients with type 2 diabetes mellitus after percutaneous coronary intervention.

Session The increasing evidence for cardiac rehabilitation

Speaker Maria Jose Romero Reyes

Event : ESC Congress 2015

  • Topic : preventive cardiology
  • Sub-topic : Rehabilitation: Outcomes
  • Session type : Rapid Fire Abstracts

Authors : M J Romero Reyes (Seville,ES), N Cobo Gomez (Seville,ES), P Escane Duarte (Seville,ES), R Picon Heras (Seville,ES), R Guerola Segura (Seville,ES), FJ Molano Casimiro (Seville,ES), L Pastor Torres (Seville,ES)

Authors:
M.J. Romero Reyes1 , N. Cobo Gomez1 , P. Escane Duarte1 , R. Picon Heras1 , R. Guerola Segura1 , F.J. Molano Casimiro1 , L. Pastor Torres1 , 1University Hospital Virgen de Valme, Cardiology - Seville - Spain ,

Citation:
European Heart Journal ( 2015 ) 36 ( Abstract Supplement ), 517

Introduction: Patients with diabetes mellitus are at increased risk of recurrent cardiovascular events after percutaneous coronary intervention.

Purpose: The aim of this study was to asses if cardiac rehabilitation decreases mortality and recurrence of cardiovascular events in this subgroup of patients after percutaneous coronary intervention.

Methods: We performed a retrospective cohort study of 318 consecutive patients with type 2 diabetes mellitus who underwent percutaneous coronary intervention in our hospital between September 2004 and January 2011. We classified the patients in two cohorts according to their participation (n=154) or not (n=164) in a cardiac rehabilitation programme. Events occurring in the first 2 years of follow-up were recorded.

Results: CR was associated with a significant decrease in all-cause mortality (OR 0,105 [95% CI: 0,31–0,356]; p<0,001) and cardiac mortality (OR 0,107 [95% IC: 0,24–0,468]; p<0,001) over a two year follow-up. No significant differences were observed in nonfatal myocardial infarction, stent restenosis and nonfatal stroke.

Conclusion: Participation in a CR programme after percutaneous coronary intervention is associated with a significant reduction in cardiac mortality and all-cause mortality rates in type 2 diabetic patients.

CR (n=154)No CR (n=164)P Value
Male sex133 (86%)100 (61%)0,000
Age (years)58±765±60,000
Hypertension113 (74%)111 (68%)0,228
Hypercholesterolemia112 (74%)115 (70%)0,423
Smoking102 (67%)75 (46%)0,000
Prior myocardial infarction24 (16%)32 (19%)0,372
Diastolic dysfunction (FE <50%)31 (22%)33 (23%)0,777
Multivessel disease79 (51%)116 (70%)0,000
Indication of revascularization:0,001
  Stable angina5 (3%)7 (4%)
  Unstable angina53 (35%)89 (56%)
  Myocardial infarction92 (60%)59 (37%)
  Cardiogenic shock2 (1%)4 (2%)
Incomplete revascularization80 (52%)81 (49%)0,648
Drug-eluting stent110 (79%)127 (80%)0,699
Stent diameter2,9±0,42,9±0,40,929
Stent length22±1124±140,265

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