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Prognostic factors for STEMI patients after cardiac rehabilitation in single academic cardiologic center.

Session Poster session 3

Speaker Sonia Borodzicz-Jazdzyk

Event : Heart Failure 2017

  • Topic : preventive cardiology
  • Sub-topic : Exercise Testing
  • Session type : Poster Session

Authors : S Borodzicz (Warsaw,PL), P Balsam (Warsaw,PL), M Peller (Warsaw,PL), R Glowczynska (Warsaw,PL), L Koltowski (Warsaw,PL), P Lodzinski (Warsaw,PL), KJ Filipiak (Warsaw,PL), M Grabowski (Warsaw,PL), G Opolski (Warsaw,PL)

Authors:
S Borodzicz1 , P Balsam1 , M Peller1 , R Glowczynska1 , L Koltowski1 , P Lodzinski1 , KJ Filipiak1 , M Grabowski1 , G Opolski1 , 1Medical University of Warsaw, 1st Chair and Department of Cardiology - Warsaw - Poland ,

Citation:
European Journal of Heart Failure ( 2017 ) 19 ( Suppl. S1 ), 492

Introduction: Cardiac rehabilitation (CR) has well-established efficiency in improving the prognosis of patients after ST-elevated myocardial infarction (STEMI).

Purpose: The main aim of our study was to analyse early and late factors which may be related to the improved prognosis of STEMI patients who participated in CR programme.

Methods: It was a retrospective analysis of STEMI patients who underwent invasive coronary angiography and percutaneous coronary intervention (PCI) after STEMI followed by CR in years 2007-2013. The group consisted of 141 patients; the average time of follow-up was 30 ± 14 months (max. 96 months). Individual physical capacity was assessed at the beginning of CR by electrocardiographic exercise test. Information on patients’ current activity was assessed with validated International Physical Activity Questionnaire (IPAQ). The analysed early factors included: gender, age, body mass index (BMI), hypertension, diabetes mellitus type 2, atrial fibrillation, history of previous MI or stroke, ejection fraction, type of infarction related artery, localization of MI, peak levels of troponin I (TnI), creatine kinase-MB (CK-MB) mass. Late factors included: initial metabolic equivalent of task score (METs), METs after CR, improvement of METs, number of training sessions (12 or 24). The combined end point consisted of: patient’s death or another cardiovascular event (stroke, myocardial infarction, any revascularisation).

Results : Higher BMI was associated with better prognosis of patients (Hazard Ratio HR=0.83; 95% Confidence Interval CI 0.71-0.93; p=0.012). There was observed a trend for the relation between the improvement of METs and better prognosis of patients (HR=0.57; 95% CI 0.38-0.86; p=0.007). No statistically significant relation between any of the early and late factors and any form of physical activity was found.

Conclusions : Increased BMI, itself a risk factor for coronary artery disease, is a positive prognostic factor for the outcome of CR (phenomenon known as the obesity paradox). Our study also shows that although the absolute value of METs achieved after CR had no significant impact, the thing that seems to improve prognosis is relative improvement of METs.

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