TY - JOUR
T1 - Cardiac rehabilitation of elderly patients in eight rehabilitation units in western Europe
T2 - Outcome data from the EU-CaRE multi-centre observational study
AU - Prescott, Eva
AU - Eser, Prisca
AU - Mikkelsen, Nicolai
AU - Holdgaard, Annette
AU - Marcin, Thimo
AU - Wilhelm, Matthias
AU - Gil, Carlos Peña
AU - González-Juanatey, José R
AU - Moatemri, Feriel
AU - Iliou, Marie Christine
AU - Schneider, Steffen
AU - Schromm, Eike
AU - Zeymer, Uwe
AU - Meindersma, Esther P
AU - Crocamo, Antonio
AU - Ardissino, Diego
AU - Kolkman, Evelien K
AU - Prins, Leonie F
AU - van der Velde, Astrid E
AU - Van't Hof, Arnoud Wj
AU - de Kluiver, Ed P
PY - 2020/11
Y1 - 2020/11
N2 - AIMS: The European Cardiac Rehabilitation in the Elderly (EU-CaRE) HORIZON 2020 project compares the sustainable effects of cardiac rehabilitation (CR) in elderly patients.METHODS AND RESULTS: A total of 1633 patients with coronary artery disease (CAD) or heart valve replacement (HVR), with or without revascularization, aged 65 or above, who participated in CR were included. Peak oxygen uptake (VO2peak), smoking, body mass index, diet, physical activity, serum lipids, psychological distress and medication were assessed before and after CR (T0 and T1) and after 12 months (T2). Patients undergoing coronary artery bypass surgery or surgical HVR had lower VO2peak at T0 and a greater increase to T1 and T2 (2.8 and 4.4 ml/kg/min, respectively) than CAD patients undergoing percutaneous or no revascularization (1.6 and 1.4 ml/kg/min, respectively). After multivariable adjustment, earlier CR uptake was associated with greater improvements in VO2peak. The proportion of CAD patients with three or more uncontrolled risk factors declined from 58.4% at T0 to 40.1% at T2 (p < 0.0001). Psychological distress scores all improved and adherence to medication was overall good at all sites. There were significant differences in risk factor burden across sites, but no CR program was superior to others.CONCLUSIONS: The outcomes of VO2peak in CR programs across Europe seemed mainly determined by timing of uptake and were maintained or even further improved at 1-year follow-up. Despite significant improvements, 40.1% of CAD patients still had three or more risk factors not at target after 1 year. Differences across sites could not be ascribed to characteristics of the CR programs offered.
AB - AIMS: The European Cardiac Rehabilitation in the Elderly (EU-CaRE) HORIZON 2020 project compares the sustainable effects of cardiac rehabilitation (CR) in elderly patients.METHODS AND RESULTS: A total of 1633 patients with coronary artery disease (CAD) or heart valve replacement (HVR), with or without revascularization, aged 65 or above, who participated in CR were included. Peak oxygen uptake (VO2peak), smoking, body mass index, diet, physical activity, serum lipids, psychological distress and medication were assessed before and after CR (T0 and T1) and after 12 months (T2). Patients undergoing coronary artery bypass surgery or surgical HVR had lower VO2peak at T0 and a greater increase to T1 and T2 (2.8 and 4.4 ml/kg/min, respectively) than CAD patients undergoing percutaneous or no revascularization (1.6 and 1.4 ml/kg/min, respectively). After multivariable adjustment, earlier CR uptake was associated with greater improvements in VO2peak. The proportion of CAD patients with three or more uncontrolled risk factors declined from 58.4% at T0 to 40.1% at T2 (p < 0.0001). Psychological distress scores all improved and adherence to medication was overall good at all sites. There were significant differences in risk factor burden across sites, but no CR program was superior to others.CONCLUSIONS: The outcomes of VO2peak in CR programs across Europe seemed mainly determined by timing of uptake and were maintained or even further improved at 1-year follow-up. Despite significant improvements, 40.1% of CAD patients still had three or more risk factors not at target after 1 year. Differences across sites could not be ascribed to characteristics of the CR programs offered.
KW - Cardiac rehabilitation
KW - cardiorespiratory fitness
KW - elderly
KW - exercise training
KW - psychological distress
KW - quality of life
KW - secondary prevention
UR - http://www.scopus.com/inward/record.url?scp=85081694611&partnerID=8YFLogxK
U2 - 10.1177/2047487320903869
DO - 10.1177/2047487320903869
M3 - Journal article
C2 - 32102550
SN - 2047-4873
VL - 27
SP - 1716
EP - 1729
JO - European Journal of Preventive Cardiology
JF - European Journal of Preventive Cardiology
IS - 16
ER -