Abstract 17730: The Appropriate Biomarker of a Cardiac Rehabilitation in the Patients With Post Abdominal Aortic Aneurysm Repair

Abstract

Introduction: The useful biomarkers of cardiac rehabilitation after post cardiovascular surgery are still unknown. This is the first report describing the markers of the effect of cardiac rehabilitation on prognosis after abdominal aortic aneurysm (AAA) surgery. Methods: We conducted an observed cohort study on 1330 patients receiving surgical repair of AAA in the multicenter in Tokyo from January 2003 to December 2014. The patients who had cardiac rehabilitation more than once a week for more than 3 months after surgery were classified into rehabilitation group. The patients in rehabilitation group underwent cardiopulmonary exercise testing (CPX) before and 3 months after surgery. Total 274 inspection items including blood culture, computerized tomography, carotid duplex, ankle-brachial index test, cardiac echography, respiratory function test and CPX were cyclopaedically analyzed. The results of blood culture in rehabilitation group were compared to those in non-rehabilitaion group before surgery, 14 days after and 30days after surgery. Results: The average age of patients was 73±8 years and the average follow-up period was 2.5±2.2 years. The 355 patients had cardiac rehabilitation after AAA repair, and the other 975 patients did not. Basal characteristics including age, gender, hypertension, dyslipidemia, diabetes, smoking and drugs were statistically similar in both groups. The predictors of the risk of major adverse cardiac events (MACE) after surgery were co-existence of coronary artery disease, non-intake of beta-blockers, non-intake of ARBs and nonparticipation in cardiac rehabilitation. The ROC curve analysis of the markers demonstrated no remarkable marker for the risk of MACE after surgery. But the level of CRP in rehabilitation group was lower 14 days and 30 days after surgery compared to which in non-rehabilitation group (4.5 ± 4.3 mg/dl vs. 5.9 ± 6.5 mg/dl, p<0.001 and 4.2 ± 4.5 mg/dl vs. 6.5 ± 6.0 mg/dl, p<0.001), although the level of CRP was similar in both groups before surgery. Conclusions: Cardiac rehabilitation in patients after AAA surgery improved the risk of MACE, and especially CRP may be useful as a convenient marker of effective rehabilitation for secondary prevention of arteriosclerosis.