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CANCELLED - The effect of home-based cardiac rehabilitation following coronary artery bypass graft surgery in a low income country: A controlled trial

Session Patient management - From oral treatment to transplant

Speaker Jamal Uddin

Congress : Heart Failure 2018

  • Topic : interventional cardiology and cardiovascular surgery
  • Sub-topic : Cardiovascular Surgery - Other
  • Session type : Rapid Fire Abstracts
  • FP Number : 1539

Authors : J Uddin (Dhaka,BD)

15 views

Authors:
J Uddin1 , 1Ibrahim Cardiac Hospital & Research Institute - Dhaka - Bangladesh ,

Citation:

Background: CVD is the leading cause of mortality and morbidity in Lower and low to middle income countries, including Bangladesh. To date no controlled trials of cardiac rehabilitation (CR) have been conducted in low or low to middle income countries (LLMICs).

Methods: A quasi-randomised controlled trial comparing home-based CR plus usual care (CR group) to usual care alone (UC group) for patients following coronary artery bypass graft (CABG) surgery. CR consisted of an initial CR class, an educational booklet with details of a home-based exercise programme, and monthly telephone calls from a CR team member over a 12-month period. The outcomes of maximal oxygen uptake (VO2max), coronary risk factors, health-related quality of life, and mental health status were collected at baseline between at 3 and 6 months follow-up. Differences in outcomes between groups were compared in patients with complete outcome data.

Results: A total of 142 participants participated in the trial; 71 patients in each group. At 12-months follow-up, 61 (86%) patients in the CR group and 40 (56%) in the UC group provided complete outcome data.VO2maxwas higher in CR compared to UC group (mean difference: 7 ml/kg/min, 95% CI: 2 to 11, P = 0.005).In addition, greater improvements in health-related quality of life, and coronary heart disease (CHD) risk factors were seen for CR group compared to UC group.

Conclusions: In the context of a low-income country, the addition of a home-based CR programme supported by telephone calls following CABG surgery has been shown to provide important patient benefits compared to usual care alone.

Risk factors

CR group, (n=61)

UC group, (n=40)

Baseline

Mean (SD)

6-months follow-up

Mean (SD)

Within group Mean change (95% CI)

p-value

Baseline

Mean (SD)

6-months follow-up

Mean (SD)

With group mean change (95% CI)

p-value

Between group; mean difference& (95% CI)

P-Value

BMI (kg/m2)

25.54

(2.53)

24.63

(2.26)

.91 (0.07 to 1.75)

0.03

24.77 (2.86)

24.47(2.6 to 8.00)

0.29 (-0.94 to 1.53)

0.63

-0.61 (-1.07 to -0.16)

0.008

SBP (mm Hg)

122.95 (13.02)

114.42

(6.71)

8.52 (4.93 to 12.11)

<0.001

126.75 (15.56)

116.87 (10.23)

9.87 (4.08 to 15.66)

0.001

1.35 (-4.21 to 6.90)

o.63

DBP(mm Hg)

77.45 (8.38)

74.01 (5.68)

3.44 (0.86 to 6.02 )

0.009

79.75 (7.64)

76.62 (6.34)

3.12 (-0.009 to 6.25)

0.05

-0.31 (-0.39 to 3.33)

0.86

Total cholesterol (mg/dl)

179.98 (53.17)

112.29

(36.40)

67.68 (50.95 to 84.42)

<0.001

175.27 (55.96)

160.57 (53.35)

14.70 (-9.63 to 39.03)

0.23

-52.98 (-80.41 to 25.55)

<.001

LDL-cholesterol(mg/dl)

131.44 (54.46)

87.14 (23.17)

44.30 (28.83 to 59.76)

<0.001

123.14 (56.38)

119.05 (40.31)

4.09 (-17.43 to 25.61)

0.70

-40.21 (-60.26 to 20.15)

<0.001

Triglycerides (mg/dl)

180.42 (114.36)

108.85 (48.83)

71.57 (39.02 to 104.12)

<0.001

179.92 (75.94)

161.37 (64.72)

18.55 (-12.53 to 49.63)

0.23

-53.02 (-86.24 to -19.80)

0.002

HDL-cholesterol (mg/dl)

30.80 (6.50)

35.34 (4.79)

-4.54 (-6.56 to -2.51)

<0.001

29.40 (6.53)

30.80 (4.94)

-1.00 (-3.77 to 1.77)

0.47

3.54 (0.81 to 6.26)

0.01

HbA1c(mg/ml)

7.46 (2.07)

6.28 (0.92)

1.18 (0.58 to 1.77)

<0.001

7.11 (1.5)

6.42 (1.03)

0.68 (0.11 to 1.26 )

0.019

-0.49 (-1.14 to 0.16)

0.14

Between group difference in baseline and 6-month follow-up clinical risk factors


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