Abstract 12274: Intensive Cardiac Rehabilitation: Impact on Mortality

Abstract

Introduction: Intensive cardiac rehabilitation (ICR) combines exercise sessions as in traditional cardiac rehabilitation (CR) with additional educational sessions focused on a heart-healthy diet and a healthy mindset. The effects of ICR, particularly outpatient Pritikin ICR, on mortality and cardiovascular outcomes have not been evaluated. Thus, the aim of our study is 1) to prospectively evaluate survival in a large cohort of patients enrolled in an outpatient Pritikin ICR program; and 2) to compare survival within a 5% Medicare sample between beneficiaries who participated in ICR versus those who did not participate in cardiac rehabilitation. Hypothesis: We hypothesize that 1) outpatient Pritikin ICR is associated with excellent survival (i.e. over 90% at 1 year) and 2) Medicare beneficiaries participating in ICR have better survival than those not participating in any cardiac rehabilitation. Methods: 1) This is a prospective longitudinal study of participants engaging in ICR at the first-ever outpatient Pritikin ICR center. For the single-center data, mortality was obtained via review of electronic medical records and direct patient follow-up for 1 year. 2) Within a 5% national Medicare sample, mortality was evaluated in all subjects utilizing a Cox proportional hazard model adjusted for age, gender, Medicaid status, number of comorbidities, and qualifying event type. The Kaplan-Meier curve is based on a subgroup matched for these same variables. Results: 1) There were 433 patients who participated in Pritikin ICR at our institution. The survival rate was 98% at 1 year. 2) In the Medicare sample, enrollees in ICR had a lower mortality than those not attending cardiac rehabilitation (HR = 0.49, 95% CI 0.28, 0.86) after adjustments; median follow-up time was 27.0 months. Conclusions: Outpatient Pritikin ICR is associated with an outstanding survival rate at 1 year. ICR in general is associated with better survival rates, even after multivariable adjustment.