title: Impact of exercise-based cardiac rehabilitation on long-term clinical outcomes in patients with left main coronary artery stenosis.
abstract: Cardiac rehabilitation may reduce cardiovascular mortality and morbidity rates in patients with coronary artery disease. The specific relationship between cardiac rehabilitation participation and left main coronary artery stenosis is unknown.
  
  
  
  Prospective registry analysis.
  
  
  
  Data from a registry of 3120 patients with left main coronary artery stenosis, collected between 1995 and 2010, were analyzed. A total of 596 patients (19.6%) had participated in a cardiac rehabilitation program.
  
  
  
  The crude seven-year mortality, cardiovascular mortality, target-vessel revascularization and myocardial infarction rates were significantly lower in the cardiac rehabilitation than in the non-rehabilitation group, and the incidence of stroke tended to be lower in the cardiac rehabilitation group. Multivariate analysis showed that cardiac rehabilitation was associated with significantly lower risks of mortality (hazard ratio (HR), 0.70; 95% confidence interval (CI), 0.49-1.00; p = 0.05) and cardiovascular mortality (HR, 0.69; 95% CI, 0.48-0.97; p = 0.03). However, the adjusted HR of myocardial infarction, target-vessel revascularization and stroke did not differ significantly. Propensity score-matched analysis of 507 pairs showed that cardiac rehabilitation was associated with significant decreases in mortality (HR, 0.62; 95% CI, 0.43-0.89; p = 0.009) and cardiovascular mortality (HR, 0.54; 95% CI, 0.36-0.80; p = 0.002) but had no beneficial effects on myocardial infarction, target-vessel revascularization or stroke.
  
  
  
  Exercise-based cardiac rehabilitation participation was associated with significant decreases in mortality. Our findings show that cardiac rehabilitation programs should be implemented in standard management for patients with left main coronary artery stenosis.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Jong-Young
authors.initials: JY
authors.lastname: Lee
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Asan Medical Center, College of Medicine University of Ulsan, Seoul, Republic of Korea.
authors.forename: Jung-Min
authors.initials: JM
authors.lastname: Ahn
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Asan Medical Center, College of Medicine University of Ulsan, Seoul, Republic of Korea.
authors.forename: Duk-Woo
authors.initials: DW
authors.lastname: Park
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Asan Medical Center, College of Medicine University of Ulsan, Seoul, Republic of Korea.
authors.forename: Soo-Jin
authors.initials: SJ
authors.lastname: Kang
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Asan Medical Center, College of Medicine University of Ulsan, Seoul, Republic of Korea.
authors.forename: Young-Hak
authors.initials: YH
authors.lastname: Kim
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Asan Medical Center, College of Medicine University of Ulsan, Seoul, Republic of Korea.
authors.forename: Seung-Whan
authors.initials: SW
authors.lastname: Lee
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Asan Medical Center, College of Medicine University of Ulsan, Seoul, Republic of Korea.
authors.forename: Cheol Whan
authors.initials: CW
authors.lastname: Lee
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Asan Medical Center, College of Medicine University of Ulsan, Seoul, Republic of Korea.
authors.forename: Seong-Wook
authors.initials: SW
authors.lastname: Park
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Asan Medical Center, College of Medicine University of Ulsan, Seoul, Republic of Korea sjpark@amc.seoul.kr.
authors.forename: Seung-Jung
authors.initials: SJ
authors.lastname: Park
mesh_terms: D000072038:Cardiac Rehabilitation / Q000379:methods*; D002423:Cause of Death / Q000639:trends; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000175:diagnosis / Q000401:mortality / Q000534:rehabilitation*; D005081:Exercise Therapy / Q000379:methods*; D017079:Exercise Tolerance / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012042:Registries; D056910:Republic of Korea / Q000453:epidemiology; D015996:Survival Rate / Q000639:trends
keywords: Cardiac; death; rehabilitation