Abstract
Prognosis of coronary heart disease depends on correction of cardiovascular risk factors and long-term maintenance. Little data exist on the relationship between the patient’s profile and durable adhesion to the new learned behaviors in cardiac rehabilitation. The aim of our study was to investigate predictors of maintaining the cardiac rehabilitation program benefits at one year. From November 2012 to December 2013, 127 patients undergoing cardiac rehabilitation after a coronary event were included. One year after the end of the program, four main goals (smoking cessation, body mass index <25, regular physical activity and professional recovery) were collected. We analyzed their relationship with clinical and socio-demographic data. Smoking cessation was significantly associated with regular physical activity.Body mass index <25 was significantly associated with absence of diabetes (p=0.016) and dyslipidemia (p=0.005).Regular physical activity was significantly associated with BMI lower (28,8 vs27, p=0.046).Professional recovery was significantly associated with Left Ventricular Ejection Fraction >55% (p=0.037), dyspnea NHYA 1 (p=0.015) and better functional abilities at the end of rehabilitation cycle (8.1 mets vs 6.4 mets, p<0,001) and one year later (7,4 mets vs 5,1 mets p=0.001). LVEF preserved, low degree of dyspnea, functional abilities >6 METs appear as positive prognostic factors for professional recovery.Our study highlights the constant interaction between correction of cardiovascular risk factors and adaptation of lifestyle (physical activity, diet). Patients with many cardiovascular risk factors fail in achieving or maintaining the goals acquired during cardiac rehabilitation program, since several simultaneous changes in behavior are recquired. Because of the chronic and multifactorial nature of coronary artery disease, new personnalized monitoring strategies should be thoughtful, to ensure personalized care.
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