title: Predictors of Suboptimal Gain in Exercise Capacity After Cardiac Rehabilitation.
abstract: Cardiac rehabilitation (CR) improves exercise capacity (EC), but not all CR participants achieve such improvements. Our primary aim was to develop a tool to identify those with suboptimal improvement in EC after CR. We retrospectively analyzed 541 patients enrolled in a phase-II CR program after a cardiac event or intervention from 2003 to 2014. EC was assessed with the 6-minute walk test. We developed a multivariate linear regression model and corresponding nomogram to predict EC after CR. The predictors included in the final model were age, gender, baseline EC, primary referral diagnosis, body mass index, systolic blood pressure at rest, triglycerides, low-density lipoprotein cholesterol, lipid-lowering medication use, and an interaction term of low-density lipoprotein cholesterol with lipid-lowering therapy. The prediction model was internally validated using bootstrap methods, and a nomogram was created for ease of use. In conclusion, this tool helps to identify those patients with suboptimal improvement in EC who could be targeted for individualized interventions to increase their performance.
authors.affiliation: Department of Cardiovascular Diseases, Mayo Clinic Florida, Jacksonville, Florida; Division of Cardiovascular Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom.
authors.forename: Johannes
authors.initials: J
authors.lastname: Bargehr
authors.affiliation: Division of Biomedical Statistics and Informatics, Mayo Clinic Florida, Jacksonville, Florida.
authors.forename: Colleen S
authors.initials: CS
authors.lastname: Thomas
authors.affiliation: Department of Cardiovascular Diseases, Mayo Clinic Florida, Jacksonville, Florida.
authors.forename: Keith R
authors.initials: KR
authors.lastname: Oken
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic Rochester, Rochester, Minnesota.
authors.forename: Randal J
authors.initials: RJ
authors.lastname: Thomas
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic Rochester, Rochester, Minnesota.
authors.forename: Francisco
authors.initials: F
authors.lastname: Lopez-Jimenez
authors.affiliation: Department of Cardiovascular Diseases, Mayo Clinic Florida, Jacksonville, Florida. Electronic address: Trejo.Jorge@mayo.edu.
authors.forename: Jorge F
authors.initials: JF
authors.lastname: Trejo-Gutierrez
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D060050:Angina, Stable / Q000534:rehabilitation*; D001794:Blood Pressure; D015992:Body Mass Index; D000072038:Cardiac Rehabilitation; D006348:Cardiac Surgical Procedures / Q000534:rehabilitation; D008078:Cholesterol, LDL / Q000097:blood; D001026:Coronary Artery Bypass / Q000534:rehabilitation*; D017079:Exercise Tolerance; D005260:Female; D006351:Heart Valves / Q000601:surgery; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000534:rehabilitation*; D049451:Nomograms; D062645:Percutaneous Coronary Intervention / Q000534:rehabilitation*; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012737:Sex Factors; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood; D000070857:Walk Test
chemical_list: D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000960:Hypolipidemic Agents; D014280:Triglycerides