In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.

The free consultation period for this content is over.

It is now only available year-round to ESC Professional Members, Fellows of the ESC, and Young combined Members

Determinants and outcome of drop-out in outpatient cardiac rehabilitation

Session Prognosis and cost-effectiveness of cardiac rehabilitation

Speaker Sofie Pardaens

Event : ESC Congress 2016

  • Topic : preventive cardiology
  • Sub-topic : Outcomes
  • Session type : Moderated Posters

Authors : S Pardaens (Ghent,BE), AM Willems (Gent,BE), D De Smedt (Ghent,BE), E Clays (Ghent,BE), M Vanderheyden (Aalst,BE), J De Sutter (Ghent,BE)

S. Pardaens1 , A.M. Willems2 , D. De Smedt1 , E. Clays1 , M. Vanderheyden3 , J. De Sutter1 , 1Ghent University - Ghent - Belgium , 2AZ Maria Middelares Hospital - Ghent - Belgium , 3Cardiovascular Center Aalst - Aalst - Belgium ,

Cardiovascular rehabilitation: interventions and outcomes

European Heart Journal ( 2016 ) 37 ( Abstract Supplement ), 622

Background: The effect of adherence to cardiac rehabilitation (CR) on outcome is not entirely clear.

Purpose: Therefore, we aimed to assess the impact of premature withdrawal of CR on outcome in coronary artery disease (CAD) patients.

Methods: 1024 CAD patients who entered CR between September 2007 and January 2013 were prospectively enrolled in the study. One-hundred patients who dropped out for medical reasons were excluded, resulting in 924 patients with acute coronary syndrome (n=388), elective percutaneous coronary intervention (n=129) or coronary artery bypass graft (n=407). Drop-out was defined as attending ≤50% of the training program, which has a maximum of 45 sessions. Differences in clinical characteristics and a combined end-point of all-cause mortality and rehospitalisation for a coronary event, cerebrovascular accident or heart failure, were assessed according to drop-out.

Results: Patients attended 36±12 training sessions on average, with 18% dropping out in the first half of the program. A median follow-up period of 33 months (interquartile range [24,51]) was completed after start of CR, which was equal between both groups of patients. Also a similar demographic and clinical profile was observed in both groups with a comparable age, gender distribution, left ventricular function and baseline exercise capacity. However, patients who withdrew prematurely from CR, had more comorbidities such as chronic obstructive pulmonary disease (p=0.049) and peripheral arterial disease (p=0.011) and were more frequently smokers at start of CR (p=0.025). These patients were also more frequently singles (p=0.07), more dependent on others to get to CR (p=0.026) and tended to report more anxiety-related problems on the Hospital Anxiety and Depression Scale (p=0.081) at start of CR. Furthermore, two years after starting CR, patients who dropped out had a significantly higher event rate than their counterparts who attended the program for more than half of the sessions. (21% versus 12%, p=0.001).

Conclusion: Drop-out is associated with an adverse outcome in CAD patients, with a higher event rate for the combined end-point of mortality and rehospitalisation among those patients that withdrew prematurely from the CR program. Therefore, patients should be encouraged to sustain their program, in particular those with comorbidities and a vulnerable psychosocial background which seems to play a predisposing role in drop-out.

Figure 1

The free consultation period for this content is over.

It is now only available year-round to ESC Professional Members, Fellows of the ESC, and Young combined Members

Get your access to resources

Join now
  • 1ESC Professional Members – access all ESC Congress resources 
  • 2ESC Association Members (Ivory, Silver, Gold) – access your Association’s resources
  • 3Under 40 or in training - with a Combined Membership, access all resources
Join now
logo esc

Our mission: To reduce the burden of cardiovascular disease

Who we are