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Long-term benefits of cardiac rehabilitation in patients with diabetes mellitus after percutaneous coronary intervention

Session Poster Session 1

Speaker Maria Jose Romero Reyes

Event : ESC Congress 2019

  • Topic : preventive cardiology
  • Sub-topic : Rehabilitation: Outcomes
  • Session type : Poster Session

Authors : M J Romero Reyes (Seville,ES), R Rodriguez Delgado (Seville,ES), I Esteve Ruiz (Seville,ES), C Otte Alba (Seville,ES), JA Mora Pardo (Seville,ES), FJ Molano Casimiro (Seville,ES)

Authors:
M J Romero Reyes1 , R Rodriguez Delgado1 , I Esteve Ruiz1 , C Otte Alba1 , JA Mora Pardo1 , FJ Molano Casimiro1 , 1University Hospital Virgen de Valme, Cardiology - Seville - Spain ,

Citation:

Introduction: After percutaneous coronary intervention (PCI), patients with diabetes have a worse prognosis than non-diabetics and are at increased risk of recurrent cardiovascular events, hospitalization and higher mortality.
Purpose: The aim of our study was to evaluate the impact of cardiac rehabilitation (CR) in this high-risk group of patients. 
Methods: We performed a retrospective cohort study of 318 consecutive patients with type 2 diabetes mellitus (DM2) who underwent PCI in our hospital between 2004 and 2011. We classi?ed the patients in two cohorts according to their participation (n=154) or not (n=164) in a CR programme. We collected the events ocurring during a median follow-up of 9 years. 
Results: Using multivariate logistic regression, we found that CR participation was associated with significantly reduced all-cause mortality (53% vs 23%, OR 2,10; IC 95%; 1,16 - 3,82; p 0,014) and cardiac mortality (3,9% vs 23,8%, OR 8,69; IC95% 2,80-26,99; p < 0,0005). CR aslo associated with a singnificant decrease in a heart failure hospitalization  (26,6% vs 10,6%, OR 2,4; IC 95% 1,06- 5,52; p < 0,035). No signi?cant differences were observed in non fatal myocardial infarction, stent restenosis and non fatal stroke.
Conclusion: CR participation after PCI is associated with lower all-cause mortality, cardiac mortality and heart failure hospitalization  rates in patients with DM2 during long-term follow-up.

Rehabilitation

(n= 153)

No Rehabilitation

(n= 164)

P vaule

Male sex

138 (86,4%)

100 (61,0%)

<0,0005

Age (years)

59 (38-74)

65 (47-74)

<0,0005

Hypertension

113 (73,9%)

111 (67,7%)

NS

Hypercholesterolemia

112 (73,7%)

115 (70,1%)

NS

HbA1c ≥ 7%

88 (66,2%)

73 (64,6%)

NS

Prior myocardial infarction

24 (15,6%)

32 (19,5%)

NS

Chronic kidney disease

6 (3,9%)

19 (11,6%)

0,012

FEVI < 50%

30 (20%)

39 (25%)

NS

Three vessel disease

53 (34,4%)

58 (35,4%)

NS

Incomplete revascularization

80 (51,9%)

81 (49,4%)

NS

Drug-eluting stent

110 (78,6%)

127 (80,4%)

NS

Stent length

22,4 ± 11,9

24,6 ± 14,8

NS

Stent diameter

2,7 ± 0,3

2,8 ± 0,4

NS

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