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