Cardiac rehabilitation and long-term prognosis in cardiovascular disease patients with cancer history

Cancer and CVD both tend to cause skeletal muscle mass loss, and their combined effects are associated with a poor prognosis. In response, studies have shown comprehensive cardiac rehabilitation (CR) to be associated with an improved prognosis, as well as reduced risk of rehospitalization, in CVD patients. However, the benefits of comprehensive CR for patients with CVD and cancer remain unclear.

The purpose of this study was to examine whether participation in outpatient CR is associated with a favorable long-term prognosis for CVD patients with a cancer history.

We retrospectively reviewed 1,502 CVD patients with a cancer history (median age: 76 [69–81] years, 968 males) who were hospitalized between 2007 and 2022. The primary and secondary outcomes were all-cause death and a composite of all-cause death and CVD-related rehospitalization, respectively. We performed propensity score matching, followed by Kaplan–Meier curves and Cox regression analysis to evaluate the association between CR and prognosis, with CR participation defined as partaking at least once within three months of discharge.

Of the 1,502 patients in this study, 136 deaths and 133 CVD-related rehospitalizations occurred (median follow-up 1.6 [0.5–3.3] years). After propensity score matching, 1,036 patients (n = 518 pairs) were included, with standardized mean differences were <0.1 for all covariates. Further, CR hazard ratios for all-cause mortality and the composite outcome were 0.60 (95% CI: 0.43–0.84, P = 0.003) and 0.72 (95% CI: 0.55–0.94, P = 0.015), respectively.

Participation in outpatient CR was associated with a favorable prognosis in CVD patients with a cancer history.