Abstract
ABSTRACTBackgroundCardiac risk stratification is related to the risk of the occurrence of events induced by exercise. Despite the existence of several protocols to calculate risk stratification, studies indicating that there is similarity between these protocols are still unknown.ObjectiveTo evaluate the agreement between the existing protocols on cardiac risk rating in cardiac patients.MethodThe records of 50 patients from a cardiac rehabilitation program were analyzed, from which the following information was extracted: age, sex, weight, height, clinical diagnosis, medical history, risk factors, associated diseases, and the results from the most recent laboratory and complementary tests performed. This information was used for risk stratification of the patients in the protocols of the American College of Sports Medicine, the Brazilian Society of Cardiology, the American Heart Association, the protocol designed by Frederic J. Pashkow, the American Association of Cardiovascular and Pulmonary Rehabilitation, the Société Française de Cardiologie, and the Sociedad Española de Cardiología. Descriptive statistics were used to characterize the sample and the analysis of agreement between the protocols was calculated using the Kappa coefficient. Differences were considered with a significance level of 5%.ResultsOf the 21 analyses of agreement, 12 were considered significant between the protocols used for risk classification, with nine classified as moderate and three as low. No agreements were classified as excellent. Different proportions were observed in each risk category, with significant differences between the protocols for all risk categories.ConclusionThe agreements between the protocols were considered low and moderate and the risk proportions differed between protocols.
Highlights
Cardiovascular diseases (CVD) are the leading cause of death in most countries, including Brazil, accounting for about 20% of all deaths in individuals over 30 years of age[1,2]
The patient records were analyzed and the following information extracted: age, gender, weight, height, clinical diagnosis for which the patient was referred to the heart disease unit, medical history, risk factors (RF) for the development of CVD, associated diseases, and the results of recent laboratory tests and complementary tests related to the evaluation of the cardiovascular system
Of the patients who had a main diagnosis of coronary artery disease (CAD), 37.0% (n=10) underwent angioplasty with stent placement, 33.3% (n=9) coronary artery bypass grafting (CABG), 7.4% (n=2) both stent and CABG, and 22.2% (n=6) performed conservative treatment
Summary
Cardiovascular diseases (CVD) are the leading cause of death in most countries, including Brazil, accounting for about 20% of all deaths in individuals over 30 years of age[1,2]. In addition to the high mortality rate, these diseases may be responsible for physical disability and contribute significantly to increased spending on health[1]. This scenario demonstrates the need for effective interventions, of which cardiac rehabilitation (CR) seems to be one example. The central idea for CR is to perform exercise, the prescription of wich should be made on an individual basis in order to provide beneficial effects and safety during performance[6,7]. The first step for the prescription is to conduct a thorough evaluation of the clinical and
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