Metabolic outcome analysis of patients with and without diabetes mellitus undergoing cardiac rehabilitation for ischaemic heart disease

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Patients with T2DM have reduced benefit from cardiac rehabilitation compared to non-diabetics. Additionally, diabetics are less likely to follow up after rehab completion. The European Society of Cardiology (ESC) recommend the use of SGLT2 inhibitors and GLP-1 analogues for T2DM with coronary artery disease. Both classes reduce all-cause mortality, improve HbA1C and obesity. Purpose We analysed our cardiac rehab population, comparing outcomes of patients with T2DM to those without; additionally, we appraised outcomes of new agents compared to prior standard care. Methods 180 patients were analysed, 90 diabetics and 90 non-diabetics. Data from 2016-2020 was reviewed. Sub-analysis was performed on those treated with SGLT2 inhibitors or GLP-1 analogues. Statistics performed on IBM SPSS v.26. Results Data points are displayed in Table 1. Patients on GLP-1/SGLT2 therapy comprised 14.44% (n = 13) of diabetics. Prescription of these agents increased from 0% in 2016 to 45% in 2020. Mean BMI loss in this group was comparable to non-diabetics, at 0.3615 kg/m2. Conclusions HTN and obesity was higher in diabetics, with lower total cholesterol - possibly explained by earlier recognition and treatment. BMI loss for non-diabetics was 2.13 times that of diabetics (0.362 kg/m2 vs 0.171 kg/m2, p = 0.2), but comparable to those on SGLT2 or GLP-1 therapy (0.3615 kg/m2). Use of these agents increased significantly as robust data became available. Table 1CategoryNon-Diabetics (Mean)Diabetics (Mean)P-ValueAge (Years)66.1 (SD +/- 8.73)67.73 (SD +/- 8.88)0.21Sex (Male)58%54%0.41Smoker or Ex25%27.7%0.52PCI (% of total)78%82%0.48CABG (% of total)22%18%0.74Cholesterol (mmol/L)4.21 (SD +/- 1.29)3.57 (SD +/- 0.9)<0.001BMI (kg/m2)- Prior27.56 (SD +/- 3.11)31.76 (SD +/- 5.89)<0.001BMI (kg/m2)- Post27.19 (SD +/- 3.13)30.98 (SD +/- 6.16)<0.001Change in BMI0.363 (SD +/- 0.525)0.171 (SD +/- 1.33)0.21Resting Heart Rate - Prior73.32 (SD +/- 10.75)76.94 (SD +/- 13.22)0.059Resting Heart Rate - Post69.46 (SD +/- 10.01)75.29 (SD +/- 11.21)<0.001Systolic BP (mmHg) - Prior141.9 (SD +/- 18.89)150.5 (SD +/- 18.87)0.0026Systolic BP (mmHG) - Post135.2 (SD +/- 17.65)140 (SD +/- 19.26)0.07Comparison of baseline demographics and metabolic data of those with diabetes mellitus to those without.