0487: Benefits and safety of early referral to cardiac rehabilitation after acute coronary syndrome

Abstract

Cardiac rehabilitation (CR) is recommended after acute coronary syndrome (ACS), as it reduces morbidity and improves quality of life. In France, about 20 to 30% of patients are referred to CR after ACS. The aim of our study is to evaluate if early referral (<7 days) is safe and if it provides immediate further benefits. From April 2014 to April 2015, thirty nine patients were referred to CR after their discharge from cardiac care unit (one center). The early referral group (ERG) included 16 patients, all of them had their first medical contact in CR within 7 days after ACS. The late referral group (LRG) included 23 patients. All patients had physical examination, electrocardiogram, echocardiography and exercise test (ExT) before and at the end of CR. 21% of patients hospitalized for ACS were referred to CR. Mean age was 55.5±9.8 years with only 3 females (7.6%). The characteristics of each group are summarized in table. Abstract 0487 – Table: Characteristics of each group ERG (n=16) LRG (n=23) p Age (Years) 58.8±10.8 53.5±9.7 P=0.04 BMI (Kg/m 2 ) 25.6±2.7 25.08±2.6 NS Hypertension (%) 37.5 34.7 NS Diabetes (%) 18 17.3 NS Smoking (%) 81.2 69.56 P<0.05 ACS complications 12.5 21.7 P<0.05 Delay ACS-First medical CR contact (days) 5.8±1 13.7±8.6 P<0.05 Delay ACS-CR starting (days) 18.4±15 25.4±14 P<0.05 LV EF (%) 54.2±6.6 60.8 8.7 NS ExT before CR 7±1.1 6.9±1.6 NS METS 128.7 ±27.3 126.5±34.7 NS Workload (watts) 11.1 ±2.2 11.4±2.4 NS Number of CR sessions 0 8% NS Complications during CR (%) 8.4±2.7 8±1.9 NS Ext after CR 152.8±32 151.3±43.3 NS METS Workload (watts) No complications occurred during CR in ERG, for the LRG 2 patients had chest angina due to an incomplete initial revascularization procedure. Referral rate to CR after ACS is in the range of French national rates. Benefits of CR are similar independently from referral delay. CR is also safe even when started early after ACS.