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Depression, socioeconomic factors and ethnicity as predictors of cardiorespiratory fitness before and after cardiac rehabilitation

Session Poster Session 1

Speaker Nicolai Mikkelsen

Event : ESC Preventive Cardiology (Formerly EuroPrevent) 2018

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

Authors : N Mikkelsen (Copenhagen,DK), C Dall (Copenhagen,DK), A Holdgaard (Copenhagen,DK), M Frederiksen (Copenhagen,DK), H Rasmusen (Copenhagen,DK), E Prescott (Copenhagen,DK)

N Mikkelsen1 , C Dall1 , A Holdgaard1 , M Frederiksen1 , H Rasmusen1 , E Prescott1 , 1Bispebjerg University Hospital, Department of Cardiology - Copenhagen - Denmark ,

European Journal of Preventive Cardiology ( May 2018 ) 25 ( Supplement 1 ), 42

Background: Cardiorespiratory fitness (VO2peak) is an important predictor for all-cause mortality and morbidity and is improved following cardiac rehabilitation (CR). Cardiac patients with psychosocial or socioeconomic problems have less compliance with CR programs and may benefit less.
Purpose: To determine whether cardiac patients with psychosocial or socioeconomic problems have lower VO2peak and whether these factors modify the effect of CR.
Methods: Retrospective cohort study of patients with ischemic heart disease, valvular heart disease, or heart failure referred for CR at a single centre in Copenhagen, Denmark. VO2peak was assessed by a maximal cardiopulmonary exercise test. Preexisting depression was defined by use of antidepressants and new onset depression by a modified PRIME-MD questionnaire at CR uptake. Socioeconomic status was defined by educational attainment and working status; ethnicity as Western-European or non-Western-European.
Results: Full data from baseline assessment was available on 1217 patients and follow-up on 861 patients. Mean VO2peak before CR was 21.8 (SD+-6.8) ml/kg/min. After multivariate adjustment lower VO2peak was associated with lower educational attainment, not working and non-Western ethnicity but not with depression. Mean improvement of VO2peak following CR was 2.4 (SD+-4.3) ml/kg/min. After multivariable adjustment educational attainment, employment status and ethnicity were significant predictors of improvement of VO2peak while depression was not.
Conclusion: Education, attachment to the work force and ethnicity were all associated with lower VO2peak before CR and the disparity was increased following CR. Having pre-existing depression and new onset depression did not influence VO2peak either before or after CR. These results point to important subgroups in need of specially tailored rehabilitation programmes.

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