Little Kasara A, Smith Joshua R, Medina-Inojosa Jose R, Chacin Suarez Audry S, Taylor Jenna L, Hammer Shane M, Fischer Karen M, Bonikowske Amanda R, Squires Ray W, Thomas Randal J, Olson Thomas P
Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN.
Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN.
Mayo Clin Proc Innov Qual Outcomes. 2022 Sep 2;6(5):428-435. doi: 10.1016/j.mayocpiqo.2022.07.002. eCollection 2022 Oct.
To determine whether the number of cardiac rehabilitation (CR) sessions attended and selected clinical characteristics were predictive of patients who exhibited improvement in peak oxygen uptake (VOpeak) after CR.
Using the Rochester Epidemiology Project records-linkage system, we identified all consecutive patients aged 18 years or older from Olmsted County, Minnesota, who underwent cardiopulmonary exercise testing before and after CR from 1999 to 2017. Regression models were created to assess the clinical predictors of VOpeak improvement (>0% baseline) after CR.
The analysis included 671 patients, of which 524 (78%) patients exhibited VOpeak improvement after CR. The significant univariate predictors of VOpeak improvement included younger age (odds ratio [OR], 0.98; 95% CI, 0.96-0.99), lower pre-CR VOpeak (OR, 0.96; 95% CI, 0.94-0.99), and no history of peripheral artery disease (OR, 0.50; 95% CI, 0.31-0.81) (all, <.005). The significant independent predictors of VOpeak improvement from the multivariable analysis included the number of CR sessions (OR, 1.04; 95% CI, 1.02-1.05), younger age (OR, 0.96; 95% CI, 0.94-0.98), lower pre-CR VOpeak (OR, 0.92; 95% CI, 0.89-0.95), and no history of peripheral artery disease (OR, 0.47; 95% CI, 0.28-0.78) (all, <.005).
These findings highlight the importance of patient participation in CR sessions and individual clinical characteristics in influencing VOpeak improvement after CR in patients with cardiovascular disease.
确定参加心脏康复(CR)的疗程数以及选定的临床特征是否可预测CR后峰值摄氧量(VOpeak)出现改善的患者。
利用罗切斯特流行病学项目记录链接系统,我们识别了明尼苏达州奥尔姆斯特德县所有18岁及以上、在1999年至2017年期间接受CR前后进行心肺运动测试的连续患者。建立回归模型以评估CR后VOpeak改善(>基线0%)的临床预测因素。
分析纳入671例患者,其中524例(78%)患者CR后VOpeak出现改善。VOpeak改善的显著单因素预测因素包括年龄较小(比值比[OR],0.98;95%置信区间[CI],0.96 - 0.99)、CR前VOpeak较低(OR,0.96;95% CI,0.94 - 0.99)以及无外周动脉疾病史(OR,0.50;95% CI,0.31 - 0.81)(均P <.005)。多变量分析中VOpeak改善的显著独立预测因素包括CR疗程数(OR,1.04;95% CI,1.02 - 1.05)、年龄较小(OR,0.96;95% CI,0.94 - 0.98)、CR前VOpeak较低(OR,0.92;95% CI,0.89 - 0.95)以及无外周动脉疾病史(OR,0.47;95% CI,0.28 - 0.78)(均P <.005)。
这些发现凸显了患者参与CR疗程以及个体临床特征在影响心血管疾病患者CR后VOpeak改善方面的重要性。