title: Cardiac Rehabilitation after an Acute Coronary Syndrome: The Impact in Elderly Patients.
abstract: BACKGROUND
  Cardiac rehabilitation (CR) has been shown to decrease mortality and morbidity, improve the control of risk factors and the quality of life of patients with coronary artery disease. However, the elderly are underrepresented in most studies and in real-life CR programs. Our goal was to evaluate the impact of CR after an acute coronary syndrome in the elderly population.
  
  
  METHODS
  A cutoff of 65 years was used to dichotomize age. Our main focus was on the effects of ambulatory supervised exercise training on several surrogate markers, namely total cholesterol, low- and high-density lipoprotein cholesterol, triglycerides, body mass index, fasting glucose, glycated hemoglobin, probrain natriuretic peptide, International Physical Activity Questionnaire score, maximal exercise capacity, chronotropic response index and heart rate recovery. We evaluated those variables at the beginning and at the end of phase II of the CR program (after 3 months) and repeated the treadmill test at 12 months.
  
  
  RESULTS
  A total of 548 patients with a recent acute coronary syndrome were enrolled; 37% were 65 years old or older. Both age groups had a statistically significant improvement in all the evaluated parameters. Interestingly, at 12 months both groups maintained the improvement in functional capacity seen immediately after 3 months.
  
  
  CONCLUSIONS
  The benefits of CR in terms of functional capacity, metabolic profile and other prognostic parameters were significant in both younger and older patients. Therefore, all eligible patients should be referred to CR programs, irrespective of age.
authors.affiliation: Cardiology Department, Hospital de Santo António, Centro Hospitalar do Porto, Porto, Portugal.
authors.forename: Patrícia
authors.initials: P
authors.lastname: Rodrigues
authors.forename: Mário
authors.initials: M
authors.lastname: Santos
authors.forename: Maria João
authors.initials: MJ
authors.lastname: Sousa
authors.forename: Bruno
authors.initials: B
authors.lastname: Brochado
authors.forename: Diana
authors.initials: D
authors.lastname: Anjo
authors.forename: Ana
authors.initials: A
authors.lastname: Barreira
authors.forename: José
authors.initials: J
authors.lastname: Preza-Fernandes
authors.forename: Paulo
authors.initials: P
authors.lastname: Palma
authors.forename: Sofia
authors.initials: S
authors.lastname: Viamonte
authors.forename: Severo
authors.initials: S
authors.lastname: Torres
mesh_terms: D054058:Acute Coronary Syndrome / Q000534:rehabilitation*; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D008076:Cholesterol, HDL / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood*; D005080:Exercise Test; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL