Clinical outcomes after a home cardiac rehabilitation program

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Cardiac rehabilitation programs (CRP) still do not reach all patients with this indication. In the context of COVID-19 pandemic, the new home CRP model has been introduced. Purpose To evaluate the results in terms of control of cardiovascular risk factors (CVRF) and changes in functional capacity with home CRP. Methods Cross-sectional observational study that included 173 patients, ≥ 18 years, after acute coronary syndrome or after coronary revascularization, included in home PRHC. Electronic medical records were analyzed to collect data on baseline clinical variables at the entrance and exit after 2 months of the home CRP: smoking habit, weight, abdominal perimeter, total cholesterol, LDLc, HDLc, triglycerides, HBA1c, METS in stress test and employment status. Results A total of 173 patients has been studied. Mean age was 51.6 (SD: 7.94), 15.6% women. Indication for home CRP was non-ST-elevation myocardial infarction (NSTEMI) in 45.7% of patients, 31.8% had STEMI, 17.9% after elective coronary interventions, 3.5% after cardiac arrest, and 1.2% corresponded to other causes. Patients were at low risk in 50%, 48% moderate and 2% high risk. With 1, 2, or 3 vessels disease in 38.1%, 28.3%, and 33.5% respectively. Coronary revascularization was obtained by percutaneous interventions in 80.9% while 14.5% by surgery. Baseline 45.7% of patients were hypertensive, 71.7% dyslipidemic, 33.5% obese, 15.7% diabetic, and 14 % smoked at index admission. After two months of home CRP we obtained a reduction of 85.5% in smoking (p<0.001), improvement in lipid control (p<0.001), with a mean LDLc of 54.5 mg/dl, a loss of 4.6 kg of weight in obese people and improvement in 1.50 METS (p<0.0001). Conclusions The present study indicates that home cardiac rehabilitation programs are a valid alternative in low- and moderate-risk patients after acute coronary syndrome.