Cardiovascular rehabilitation of patients with ischemic heart disease undergoing medical treatment, percutaneous transluminal coronary angioplasty, and coronary artery bypass grafting.
OBJECTIVE
To evaluate the occurrence of death and myocardial infarction in subgroups of coronary artery disease patients with hemodynamically significant coronary stenoses undergoing treatment in a cardiovascular rehabilitation program and considered severely ill for: a) not having undergone intervention treatment; b) presenting signs of myocardial ischemia; c) presenting multivessel occlusive disease.


METHODS
Retrospective cohort study of 381 patients presented previous coronary angiography showing hemodynamically significant coronary stenoses, for which, because of the anatomic bias, intervention treatment was indicated. The patients were categorized according to the presence or absence of intervention treatment; presence or absence of ischemia in the exercise test; and number of critical coronary stenoses. Statistical analysis was performed using the Kaplan-Meier and logistic regression methods.


RESULTS
Survival probability was not different when patients undergoing medical treatment were compared to those undergoing previous intervention treatment (OR 0.813; 95% CI; 0.366-1.809); with and without evidence of ischemia in the exercise test (OR 0.785; 95% CI; 0.366-1.684); and with one-vessel coronary artery disease and with more-than-one-vessel coronary artery disease (OR 0.824, 95% CI; 0.377-1.798).


CONCLUSIONS
In this cohort study, no unfavorable outcome was observed in the subgroups comprised of medically treated patients, with evidence of myocardial ischemia and with multivessel coronary artery disease.
de Carvalho
Tales
T
Centro de Educação Física e Fisioterapia da Universidade do Estado de Santa Catarina, Instituto de Matemática e Estatística da Universidade de São Paulo, São Paulo, SP, Brazil. tales@cardiol.br
Curi
Ana Luiza Hallal
AL
Andrade
Dalton Francisco
DF
Singer
Julio da Motta
Jda M
Benetti
Magnus
M
Mansur
Alfredo José
AJ
D015906:Angioplasty, Balloon, Coronary / Q000534:rehabilitation*; D015331:Cohort Studies; D001026:Coronary Artery Bypass / Q000534:rehabilitation*; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000401:mortality / Q000628:therapy*; D012046:Rehabilitation; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome