Prognostic utility of a new risk stratification protocol for secondary prevention in patients attending cardiac rehabilitation

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• dc.contributor.author Cabrera-Aguilera, Ignacio
• dc.contributor.author Ivern Díaz, Consol
• dc.contributor.author Badosa Marcé, Neus
• dc.contributor.author Marco Navarro, Ester
• dc.contributor.author Duran Jordà, Xavier, 1974-
• dc.contributor.author Mojón Álvarez, Diana
• dc.contributor.author Vicente Elcano, Miren
• dc.contributor.author Llagostera Martín, Marc
• dc.contributor.author Farré López, Núria
• dc.contributor.author Ruíz Bustillo, Sonia
• dc.date.accessioned 2022-10-03T05:39:13Z
• dc.date.available 2022-10-03T05:39:13Z
• dc.date.issued 2022
• dc.description.abstract Several risk scores have been used to predict risk after an acute coronary syndrome (ACS), but none of these risk scores include functional class. The aim was to assess the predictive value of risk stratification (RS), including functional class, and how cardiac rehabilitation (CR) changed RS. Two hundred and thirty-eight patients with ACS from an ambispective observational registry were stratified as low (L) and no-low (NL) risk and classified according to exercise compliance; low risk and exercise (L-E), low risk and control (no exercise) (L-C), no-low risk and exercise (NL-E), and no-low risk and control (NL-C). The primary endpoint was cardiac rehospitalization. Multivariable analysis was performed to identify variables independently associated with the primary endpoint. The L group included 56.7% of patients. The primary endpoint was higher in the NL group (18.4% vs. 4.4%, p < 0.001). After adjustment for age, sex, diabetes, and exercise in multivariable analysis, HR (95% CI) was 3.83 (1.51-9.68) for cardiac rehospitalization. For RS and exercise, the prognosis varied: the L-E group had a cardiac rehospitalization rate of 2.5% compared to 26.1% in the NL-C group (p < 0.001). Completing exercise training was associated with reclassification to low-risk, associated with a better outcome. This easy-to-calculate risk score offers robust prognostic information. No-exercise groups were independently associated with the worst outcomes. Exercise-based CR program changed RS, improving classification and prognosis.
• dc.format.mimetype application/pdf
• dc.identifier.citation Cabrera-Aguilera I, Ivern C, Badosa N, Marco E, Duran X, Mojón D, Vicente M, Llagostera M, Farré N, Ruíz-Bustillo S. Prognostic utility of a new risk stratification protocol for secondary prevention in patients attending cardiac rehabilitation. J Clin Med. 2022 Mar 30;11(7):1910. DOI: 10.3390/jcm11071910
• dc.identifier.doi http://dx.doi.org/10.3390/jcm11071910
• dc.identifier.issn 2077-0383
• dc.identifier.uri http://hdl.handle.net/10230/54234
• dc.language.iso eng
• dc.publisher MDPI
• dc.relation.ispartof J Clin Med. 2022 Mar 30;11(7):1910
• dc.rights © 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri https://creativecommons.org/licenses/by/4.0/
• dc.subject.keyword Acute coronary syndrome
• dc.subject.keyword Cardiac rehabilitation
• dc.subject.keyword Event-free survival
• dc.subject.keyword Exercise training
• dc.subject.keyword Ischemic heart disease
• dc.subject.keyword Risk stratification
• dc.title Prognostic utility of a new risk stratification protocol for secondary prevention in patients attending cardiac rehabilitation
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion