A large-scale cohort study of long-term cardiac rehabilitation: A prospective cross-sectional study

Abstract

Background: Few studies have evaluated the therapeutic effect of long-term cardiac rehabilitation (CR) and no large-scale survey of cardiovascular outcomes after long-term CR is reported.

Methods: This cohort study included 9981 patients undergoing CR from 2004 to 2015. Patients who had supervised CR were divided into three groups according to CR duration: up to acute phase (until discharge, Phase I group), up to recovery phase (≤150 days, Phase II group), and up to maintenance phase (>150 days, Phase III group). Using propensity score matching, mortality and major adverse cardiovascular events (MACE) were compared among the groups.

Results: Follow-up period was 4.9 ± 3.0 years. Adult patients were divided into three groups (Phase I group: n = 4649, Phase II group: n = 3271, and Phase III group: n = 731). After propensity score matching, the risk of death and MACE was extremely lower in Phase III group than in Phase I or Phase II group (death: HR 0.47, P < 0.01, HR 0.64, P < 0.01, and MACE: HR 0.48, P < 0.01, HR 0.70, P < 0.01). Most patients in Phase II group had better survival than those in Phase I group. Subpopulations of female patients and those with dyslipidemia, smoking history, coronary artery bypass graft, or heart failure had better survival in Phase III group than in Phase II group.

Conclusions: Long-term supervised CR for patients with cardiovascular diseases is more effective than short-term CR.

Keywords: Cardiac rehabilitation; Coronary artery disease; Heart failure.