Cardiac rehabilitation in people with peripheral arterial disease: A higher risk population that benefits from completion

Devrome, Andrea; Aggarwal, Sandeep; McMurtry, M. Sean; Southern, Danielle; Hauer, Thomas; Lamb, Brea; Arena, Ross; Moore, Randy D.; Wilton, Stephen B.; Stone, James A.; Martin, Billie-Jean

doi:10.1016/j.ijcard.2019.02.070

Cited by 21 publications

(34 citation statements)

References 37 publications

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“… 39 In addition, patients with PAD referred to CR are less likely to enroll and complete CR. 40 There is the potential that an extended CR duration is necessary to increase VO 2 peak to allow these patients with PAD more pain-free exercise time. 41 In the present study, patients with the lowest VO 2 peak before CR exhibited greater likelihood of increasing VO 2 peak after CR.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Changes in Peak Oxygen Uptake After Outpatient Cardiac Rehabilitation: Importance of Cardiac Rehabilitation Attendance

Little

Smith²,

Medina‐Inojosa³

et al. 2022

Mayo Clinic Proceedings: Innovations, Quality & Outcomes

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Section: Discussionmentioning

confidence: 99%

Predictors of Changes in Peak Oxygen Uptake After Outpatient Cardiac Rehabilitation: Importance of Cardiac Rehabilitation Attendance

Little

Smith²,

Medina‐Inojosa³

et al. 2022

Mayo Clinic Proceedings: Innovations, Quality & Outcomes

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“…Другой важный аспект -необходимость проведения физических тренировок (ФТ) у больных ОЗАНК, которые способны улучшить качество жизни и длительность безболевой ходьбы [21]. Но именно у данной категории больных ФТ ассоциированы с наибольшим числом препятствий при их проведении [22]. Так, участие больных с сопутствующим ОЗАНК в 12-недельной программе кардиореабилитации привело к повышению физической работоспособности и улучшению прогноза [22].…”

Section: Discussionunclassified

Comparative Study of the Results of a Three-year Observation of Cardiologists and Surgeons in Patients with Peripheral Atherosclerosis

Sumin

Medvedeva

et al. 2019

Racionalʹnaâ farmakoterapiâ v kardiologii

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Aim. To compare the results of 3-year follow-up of patients with peripheral atherosclerosis (PA) in two patient cohorts: during outpatient monitoring by cardiologists and when observed by surgeons.Material and methods. The first group included 131 patients with PA who sought medical attention in outpatient clinic in 2013-2014 and then were observed by a surgeon. The second group is represented by 454 patients with PA who sought medical attention in outpatient clinic in 2010- 2012 and then underwent observation by a cardiologist as a part of a pilot project. The average follow-up duration in the studied groups was three years. The groups were compared according to the main demographic, anthropometric indicators, the presence of risk factors for atherosclerosis, comorbidity, the prevalence of atherothrombotic events in history, laboratory and instrumental examination data. Additionally, after 3 years of observation the incidence of deaths and amputations was assessed in groups.Results. Patients of the second group were older than these in the first group (p<0.001). Patients of the group 1 compared to the group 2 were more often overweight (p=0.005), suffered from diabetes mellitus (p<0.001), had a disability (p<0.001). Among patients of the group 2 compared with the group 1, the clinical picture of angina pectoris (p=0.001), rhythm disorders (p=0.058) were more often observed, they had a greater number of myocardial infarctions (p<0.001) and myocardial revascularization operations in the history: coronary bypass surgery (p=0.029), percutaneous coronary interventions (p<0.001), and underwent coronary angiography (p<0.001). Patients in group 2 were more likely to receive statins (p<0.001), β-blockers (p<0.001), angiotensin-converting enzyme inhibitors, and calcium channel blockers, angiotensin II receptor blockers, and antiarrhythmics (p<0.001). Pentoxifylline was prescribed more often in the first group (p<0.001). With a three-year observation of PA patients a fatal outcome occurred in 8.2% of cases, amputation – in 1.4%. In the first group, compared with the second one, there were more often observed deaths in general (p=0.023), death from cardiac causes, stroke, disability (p=0.005) and amputations (p=0.003). The risk of adverse outcomes (death and amputations) was increased in the presence of signs of chronic lower limb ischemia of stage III, a history of amputation, more than 70% stenosis and occlusions of lower limb arteries, chronic lung disease, and angina symptoms. The risk of adverse outcomes was decreased in outpatient observation by cardiologist, taking statins, aspirin, and performing exercise therapy.Conclusion. Observation of PA patients by a cardiologist results in more frequent optimal drug therapy (due to the better adherence of cardiologists to clinical recommendations for the treatment of such patients) and improves the prognosis of these patients.

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“…Notably, ET can be associated with functional improvements such as walking distance in patients with peripheral artery disease (PAD), being recommended as an important part of the management of individuals with intermittent claudication[ 8 , 99 ]. Whilst this, studies have shown that functional benefits can differ when comparing patients with CAD with those who present with both CAD and PAD[ 96 , 98 , 100 ]. Another frontier field which is rapidly expanding relates to cardio-oncology rehabilitation[ 8 , 101 ].…”

Section: Challenges To Crmentioning

confidence: 99%

Current role and future perspectives of cardiac rehabilitation in coronary heart disease

Vilela¹,

Ladeiras-Lopes²,

João³

et al. 2021

WJC

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Ischaemic heart disease (IHD) is a major cause of morbidity and mortality worldwide. While there have been major advances in this field, these patients are still a higher risk subgroup. As such, strategies to mitigate risk and tailor secondary prevention measures are of the utmost relevance. Cardiac rehabilitation (CR), encompassing several domains including exercise training, cardiovascular risk factor optimization, nutritional and psychological assessments, as well as other ancillary interventions has shown to be one of the pillars in the contemporary management of patients with IHD. Indeed, CR is associated with several benefits in this population, ranging from functional capacity to improvements in outcomes. Whilst this, there are still several issues concerning the optimal application of CR which are still not fully ascertained, such as lack of referral and completion, as well as questions related to programme design (particularly among patients with multiple comorbidities). In this review, we aim at presenting a pragmatic overview on the current role of CR in the management of individuals with IHD, while also discussing some of the caveats in the current data, as well as future concepts which could help improve the uptake and personalization of this pivotal time-tested intervention.

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Cardiac rehabilitation in people with peripheral arterial disease: A higher risk population that benefits from completion

Cited by 21 publications

References 37 publications

Predictors of Changes in Peak Oxygen Uptake After Outpatient Cardiac Rehabilitation: Importance of Cardiac Rehabilitation Attendance

Predictors of Changes in Peak Oxygen Uptake After Outpatient Cardiac Rehabilitation: Importance of Cardiac Rehabilitation Attendance

Comparative Study of the Results of a Three-year Observation of Cardiologists and Surgeons in Patients with Peripheral Atherosclerosis

Current role and future perspectives of cardiac rehabilitation in coronary heart disease

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