Effects of phase III cardiac rehabilitation on mortality and cardiovascular events in elderly patients with stable coronary artery disease.
BACKGROUND
Cardiac rehabilitation (CR) has numerous benefits, including reduction of mortality and cardiovascular events, in patients with coronary artery disease (CAD). However, the long-term effect of phase III CR in elderly patients with stable CAD is still unknown.


RESULTS
The 111 elderly male CAD patients (>or=65 years), including 37 subjects participating in supervised CR for 6 months and 74 age-matched controls, were analyzed. The patients were followed for up to 3,500 days, until the occurrence of death or 1 of the following major adverse cardiovascular events (MACE): cardiovascular death, acute coronary syndrome, refractory angina requiring revascularization, admission for congestive heart failure, or stroke. All-cause mortality tended to be lower in the CR group than in the Control group (14% vs 28%, P=0.081). The MACE incidence was significantly lower in the CR group than in the Control group (30% vs 62%, P=0.001). Multivariate Cox proportional hazard analysis showed that the MACE incidence was significantly lower in the CR group than in the Control group [adjusted hazard ratio 0.43 (95% confidence interval 0.20-0.91), P=0.027].


CONCLUSIONS
Phase III CR has the beneficial effect of reducing cardiovascular events even in elderly patients with stable CAD.
Onishi
Tomo
T
Department of Cardiovascular Medicine, Juntendo University School of Medicine.
Shimada
Kazunori
K
Sato
Hiroyuki
H
Seki
Eriko
E
Watanabe
Yoshiro
Y
Sunayama
Satoshi
S
Ohmura
Hirotoshi
H
Masaki
Yoshiyuki
Y
Nishitani
Miho
M
Fukao
Kosuke
K
Kume
Atsumi
A
Sumide
Takahiro
T
Mokuno
Hiroshi
H
Naito
Hisashi
H
Kawai
Sachio
S
Daida
Hiroyuki
H
D054058:Acute Coronary Syndrome / Q000453:epidemiology* / Q000401:mortality; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D003324:Coronary Artery Disease / Q000097:blood / Q000534:rehabilitation*; D004032:Diet; D005081:Exercise Therapy; D005500:Follow-Up Studies; D006333:Heart Failure / Q000453:epidemiology* / Q000401:mortality; D006801:Humans; D015994:Incidence; D007564:Japan; D008055:Lipids / Q000097:blood; D008297:Male; D010353:Patient Education as Topic; D016016:Proportional Hazards Models; D020521:Stroke / Q000453:epidemiology* / Q000401:mortality; D016896:Treatment Outcome
D001786:Blood Glucose; D008055:Lipids