In:
Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 144, No. Suppl_1 ( 2021-11-16)
Abstract:
Introduction: Cardiac rehabilitation (CR) is an effective intervention associated with a reduction in mortality and re-hospitalization for patients with acute coronary syndrome (ACS), but CR programs have not been fully implemented and doses are varied across patients. Hypothesis: This study aims to reveal the current practice of outpatient CR, and investigate the association between dose and long-term mortality for patients with ACS in real-world settings. Methods: We performed a nationwide retrospective cohort study using the National Database of Health Insurance Claims and Specific Health Checkups of Japan. Patients with ACS underwent percutaneous coronary intervention between April 2014 and March 2018 and outpatient CR within 180 days after admission were included. Results: Of all 202,320 patients underwent percutaneous coronary intervention for ACS, a total of 20,444 (10%) patients underwent outpatient CR. The median (IQR) number of total CR sessions was 9 (3-17) times, and the median (IQR) duration per session was 3.0 (2.1-3.0) units. Patients were divided into four groups according to the total session number (≤9 or 10≤ times) and duration per session (≤40 or 60≤ minutes). Of 20,444 patients, 3,845 patients were assigned in low-number/short-duration, 6,976 patients in low-number/long-duration, 1,874 patients in high-number/short-duration, and 7,749 patients in high-number/long-duration group, respectively. After adjustment for age, sex, infarction site, comorbidities, and treatments during hospitalization, the adjusted HR for all-cause mortality was 1.01 (95% CI: 0.80-1.26, p=0.95) in low-number/long-duration group, 0.62 (95% CI: 0.45-0.86, p=0.004) in high-number/short-duration group, 0.74 (95% CI: 0.59-0.92, p=0.007) in high-number/long-duration group, compared with low-number/short-duration group. Conclusions: The participation rate of outpatient CR after ACS was low and the doses of sessions were varied in real-world settings. Higher number of total sessions in outpatient CR was associated with a better prognosis despite the session duration.
Type of Medium:
Online Resource
ISSN:
0009-7322
,
1524-4539
DOI:
10.1161/circ.144.suppl_1.10483
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2021
detail.hit.zdb_id:
1466401-X
