Rodrigues Patrícia, Santos Mário, Sousa Maria João, Brochado Bruno, Anjo Diana, Barreira Ana, Preza-Fernandes José, Palma Paulo, Viamonte Sofia, Torres Severo
Cardiology Department, Hospital de Santo António, Centro Hospitalar do Porto, Porto, Portugal.
Cardiology. 2015;131(3):177-85. doi: 10.1159/000381824. Epub 2015 May 8.
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.
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.
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.
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.
心脏康复（CR）已被证明可降低死亡率和发病率，改善冠状动脉疾病患者的危险因素控制及生活质量。然而，在大多数研究和现实生活中的心脏康复项目中，老年人的参与率较低。我们的目标是评估急性冠状动脉综合征后心脏康复对老年人群的影响。
以65岁为界将年龄分为两组。我们主要关注门诊监督下的运动训练对几个替代指标的影响，即总胆固醇、低密度和高密度脂蛋白胆固醇、甘油三酯、体重指数、空腹血糖、糖化血红蛋白、脑钠肽前体、国际体力活动问卷得分、最大运动能力、变时反应指数和心率恢复情况。我们在心脏康复项目第二阶段开始时（3个月后）和结束时评估这些变量，并在12个月时重复进行跑步机测试。
共纳入548例近期发生急性冠状动脉综合征的患者；37%的患者年龄在65岁及以上。两个年龄组在所有评估参数上均有统计学意义上的显著改善。有趣的是，在12个月时，两组均维持了3个月后立即出现的功能能力改善。
心脏康复在功能能力、代谢状况和其他预后参数方面对年轻和老年患者均有显著益处。因此，所有符合条件的患者都应转诊至心脏康复项目，无论年龄大小。
