Cardiac Rehabilitation Phase 3 - Who are those who continue down the path?

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Cardiac Rehabilitation is recommended as secondary prevention in those patients with cardiovascular disease. Efforts to increase referral of patients after hospitalisations have been made in order to increase adherence to phase 2 CR programs. However, there are still few data regarding adherence after completion of phase programs regarging progressing to phase 3 programs. Purpose To characterize a population of patients who enrroled in a phase 3 CR program. Methods Prospective cohort study which included consecutive pts who were participating in a centre-based CR program lasting 8-12 weeks from 2019 to 2021. We analyzed prevalence of risk factors, lab echocardiographic and CPET data at beggining and 6 months after FUP. Possibility of attendance of a phase III CR program on a nearby gym was offered to everyone. Statistical analysis between both groups was performed with Chi-Squeare and Wilcoxon tests. Results We analyzed 336 patients who underwent CR (82% male, mean age 60 ±11,4 years). The majority was referred for ischemic heart disease (83%) followed by valvular heart disease (7%). Mean follow-up was 36,7± 19,2 months. Phase 3 program in a nearby facility was offered to everyone. Of those, 217 pts (mean age 59 +- 11,4 years-old, 80% male) chose not to continue and 119 pts (mean age 61 +- 11,3 years old, 81% male) were enrolled in the program. There were some differences among the two groups: ischemic heart disease was more prevalent in those who didn’t progress to Phase III (83% vs 66%, p=0.02) and, regarding risk factors, we noted a higher prevalence among those who enrolled in phase III, namely hypertension (77% vs 88%, p=0.04) and previous smoking habits (64,2% vs 71,1%, p=0.02). There were no significant differences regarding lab and echo data at the end of the program, especially ejection fraction, NTproBNP and LDL cholesterol. We failed to find differences between CPET data after 6 months follow up, although such findings might be limited by the scarcity of data in the group who transitioned to phase III. Conclusions Patients with a higher burden of risk factors showed higher interest in progressing to a phase III program. We did not find differences in cardiorrespiratory fitness evaluated by CPET, although more robust data would be needed to back such observations.