title: Clinical characteristics and course of patients with diabetes entering cardiac rehabilitation.
abstract: BACKGROUND
  Using data from the Italian SurveY on carDiac rEhabilitation (ISYDE-2008), this study provides insight into the level of implementation of Cardiac Rehabilitation (CR) in patients with diabetes.
  
  
  METHODS
  Data from 165 CR units were collected online from January 28th to February 10th, 2008.
  
  
  RESULTS
  The study cohort consisted of 2281 patients (66.9 ± 12 yrs); 475 (69.7 ± 10 yrs, 74% male) patients with diabetes and 1806 (66.2 ± 12 yrs, 72% male) non-diabetic patients. Compared to non-diabetic patients, patients with diabetes were older and showed more comorbidity [myocardial infarction (32% vs. 19%, p < 0.0001), peripheral artery disease (10% vs. 5%, p < 0.0001), chronic obstructive pulmonary disease (20% vs. 11%, p < 0.0001), chronic kidney disease (20% vs. 6%, p < 0.0001), and cognitive impairment (5% vs. 2%, p = 0.0009), respectively], and complications during CR [re-infarction (3% vs. 1%, p = 0.04), acute renal failure (9% vs. 4%, p < 0.0001), sternal revision (3% vs. 1%, p = 0.01), inotropic support/mechanical assistance (7% vs. 4%, p = 0.01), respectively]; a more complex clinical course and interventions with less functional evaluation and a different pattern of drug therapy at hospital discharge. Notably, in 51 (3%) and in 104 (6%) of the non-diabetic cohort, insulin and hypoglycemic agents were prescribed, respectively, at hospital discharge from CR suggesting a careful evaluation of the glycemic metabolism during CR program, independent of the diagnosis at the admission. Mortality was similar among diabetic compared to non-diabetic patients (1% vs. 0.5%, p = 0.23).
  
  
  CONCLUSIONS
  This survey provided a detailed overview of the clinical characteristics, complexity and more severe clinical course of diabetic patients admitted to CR.
authors.affiliation: Department of Translational Medical Sciences, Division of Internal Medicine and Cardiac Rehabilitation, University of Naples "Federico II", Naples, Italy. Electronic address: giallauria@libero.it.
authors.forename: Francesco
authors.initials: F
authors.lastname: Giallauria
authors.affiliation: Department of Critical Care Medicine and Surgery, Cardiac Rehabilitation Unit, University of Florence and Azienda Ospedaliero-Universitaria Careggi, Firenze, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Fattirolli
authors.affiliation: Cardiac Rehabilitation Unit, IRCCS Policlinico San Donato, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Tramarin
authors.affiliation: Cardiovascular Rehabilitation Unit, Le Terrazze Clinic, Cunardo, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Ambrosetti
authors.affiliation: Cardiac Rehabilitation Unit, Department of Cardiology, La Colletta Hospital, Arenzano, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Griffo
authors.affiliation: Cardiac Rehabilitation, Azienda Ospedaliera S. Anna e S. Sebastiano di Caserta, Italy.
authors.forename: Carmine
authors.initials: C
authors.lastname: Riccio
authors.affiliation: Cardiology Unit, Dr Pederzoli Clinic, Peschiera del Garda, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: De Feo
authors.affiliation: Heart Failure Unit, Cardiology, G. da Saliceto Hospital, Piacenza, Italy.
authors.forename: Massimo Francesco
authors.initials: MF
authors.lastname: Piepoli
authors.affiliation: Department of Translational Medical Sciences, Division of Internal Medicine and Cardiac Rehabilitation, University of Naples "Federico II", Naples, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Vigorito
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D000072038:Cardiac Rehabilitation; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D015331:Cohort Studies; D015897:Comorbidity; D003625:Data Collection; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology*; D018450:Disease Progression; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D001786:Blood Glucose
keywords: Cardiac rehabilitation; Cardiopulmonary exercise testing; Chronic heart failure; Diabetes; Exercise training; Myocardial infarction