Management of patients with ST-segment elevation or non-ST-segment elevation acute coronary syndromes in cardiac
Insights
Patients with ST-segment elevation acute coronary syndromes (STE-ACS) and non-ST-segment elevation ACS (NSTE-ACS) showed moderate baseline differences but both significantly improved in cardiac rehabilitation (CR). Both groups benefited from CR, showing enhanced lipid profiles, blood pressure, and fitness.
Area of Science:
- Cardiology
- Preventive Medicine
- Rehabilitation
Background:
- Limited data exist on the management of patients undergoing cardiac rehabilitation (CR) after acute coronary syndromes (ACS).
- This study compares patient characteristics, risk factor management, and treatment goal achievement in CR for ST-segment elevation ACS (STE-ACS) versus non-ST-segment elevation ACS (NSTE-ACS) patients in Germany.
Purpose of the Study:
- To describe patient profiles and risk factor management in German cardiac rehabilitation programs.
- To compare outcomes between STE-ACS and NSTE-ACS patients during inpatient CR.
Main Methods:
- Analysis of 7950 patients from the 2010 Transparency Registry to Objectify Guideline-Oriented Risk Factor Management registry.
- Patients underwent an approximately 3-week inpatient CR period.
- Comparison of baseline characteristics and outcomes based on STE-ACS or NSTE-ACS status.
Main Results:
- STE-ACS patients were younger and less frequently had diabetes, hypertension, or other risk factors (excluding smoking) compared to NSTE-ACS patients.
- At discharge, both groups showed similar achievement rates for low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglyceride goals.
- Significant improvements were observed in systolic blood pressure, maximum exercise capacity, and walking distance for both groups, with STE-ACS patients showing higher exercise capacity.
Conclusions:
- Patients with STE-ACS and NSTE-ACS exhibit moderate differences in baseline characteristics.
- Both patient groups significantly benefit from inpatient cardiac rehabilitation, experiencing improvements in lipid profiles, blood pressure, and physical fitness.
Background:
Current data on the management of patients in cardiac rehabilitation (CR) after an acute hospital stay due to ST-segment elevation or non-ST segment elevation acute coronary syndromes (STE-ACS or NSTE-ACS) are limited. We aimed to describe patient characteristics, risk factor management, and lipid target achievement of patients in CR in Germany and compare the 2 groups.
Hypothesis:
With respect to the risk factor pattern and treatment effects during a CR stay, there are important differences between STE-ACS and NSTE-ACS patients.
Methods:
Comparison of 7950 patients by STE-ACS or NSTE-ACS status in the Transparency Registry to Objectify Guideline-Oriented Risk Factor Management registry (2010) who underwent an inpatient CR period of about 3 weeks.
Results:
STE-ACS patients compared to NSTE-ACS patients were significantly younger (60.5 vs 64.4 years, P < 0.0001), and had diabetes mellitus, hypertension, or any risk factor (exception: smoking) less often. At discharge, in STE-ACS compared to NSTE-ACS patients, the low-density lipoprotein cholesterol (LDL-C) <100 mg/dL goal was achieved by 75.3% and 76.2%, respectively (LDL-C <70 mg/dL by 27.7% and 27.4%), the high-density lipoprotein cholesterol goal of >50 mg/dL in women and >40 mg/dL in men was achieved by 49.3% and 49.0%, respectively, and the triglycerides goal of <150 mg/dl was achieved by 72.3% and 74.3%, respectively (all comparisons not significant). Mean systolic and diastolic blood pressure were 121/74 and 123/74 mm Hg, respectively (P < 0.0001 systolic, diastolic not significant). The maximum exercise capacity was 110 and 102 W, respectively (P < 0.0001), and the maximum walking distance was 581 and 451 meters, respectively (P value not significant).
Conclusions:
Patients with STE-ACS and NSTE-ACS differed moderately in their baseline characteristics. Both groups benefited from the participation in CR, as their lipid profile, blood pressure, and physical fitness improved.
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