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. 2022 Sep;34(9):2195-2203.
doi: 10.1007/s40520-022-02130-y. Epub 2022 Apr 22.

Cardiac Rehabilitation in Advanced aGE after PCI for acute coronary syndromes: predictors of exercise capacity improvement in the CR-AGE ACS study

Samuele Baldasseroni  1   2 , Maria Vittoria Silverii  1 , Alessandra Pratesi  1 , Costanza Burgisser  1   2 , Francesco Orso  1   2 , Giulia Lucarelli  1 , Giada Turrin  1 , Andrea Ungar  1   2 , Niccolò Marchionni  1   2 , Francesco Fattirolli  3   4
Affiliations

Cardiac Rehabilitation in Advanced aGE after PCI for acute coronary syndromes: predictors of exercise capacity improvement in the CR-AGE ACS study

Samuele Baldasseroni et al. Aging Clin Exp Res. 2022 Sep.

Abstract

Background: The positive effect of cardiac rehabilitation (CR) on outcomes after acute coronary syndromes (ACS) is established. Nevertheless, enrollment rates into CR programs remain low, although ACS carry a high risk of functional decline particularly in the elderly.

Aim: We aimed to determine if a multidisciplinary CR improves exercise capacity in an older population discharged after ACS systematically treated with PCI.

Methods: CR-AGE ACS is a prospective, single-center, cohort study. All patients aged 75+ years consecutively referred to Cardiac Rehabilitation outpatient Unit at Careggi University Hospital, were screened for eligibility. Moderate/severe cognitive impairment, disability in 2+ basic activities of daily living, musculoskeletal diseases, contraindication to Cardiopulmonary Exercise Test, and diseases with an expected survival < 6 months, were exclusion criteria. Participants attended a CR program, based on 5-day-per-week aerobic training sessions for 4 weeks.

Results: We enrolled 253 post-ACS patients with a mean age 80.6 ± 4.4 years. After CR, 136 (56.2%) 77 (31.3%) patients obtained, respectively, at least a moderate (∆+5%) or an optimal (∆+15%) increase in VO2peak. Baseline VO2peak (- 1 ml/kg/min: OR 1.18; 95% CI 1.09-1.28), the number of training sessions (+1 session: OR 1.07; 95% CI 1.01-1.15), and mild-to-moderate baseline disability (yes vs. no: OR 0.22; 95% CI 0.01-0.57) were the predictors of VO2peak changes.

Conclusions: A CR program started early after discharge from ACS produces a significant increase in exercise capacity in very old patients with mild-to-moderate post-acute physical impairment. Baseline VO2peak, the number of training sessions, and the level of baseline disability are the independent predictors of improvement.

Keywords: Acute coronary syndrome; Cardiac rehabilitation; Elderly; Exercise capacity.

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Conflict of interest statement

All authors have no competing interests to declare that are relevant to the content of this article. All authors declare no potential conflict of interest including any financial, personal or other relationships or be perceived to influence, their work. None of the authors have any commercial relationship with industries.

Figures

Fig. 1
Fig. 1
Study flowchart
Fig. 2
Fig. 2
Changes in maximal oxygen consumption (VO2peak ml/kg/min), exercise duration (second) and percent VO2peak predicted for age and gender, from baseline to end of CR
See this image and copyright information in PMC

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