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A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program
Published on: April 19, 2019
The Impact of Selected Risk Factors on the Frequency of Cardiac Rehabilitation: Part I
Andrzej Kleinrok1, Marlena Krawczyk-Suszek2, Beata Zams3
1Faculty of Health Sciences, Vincent Pol University, 20-816 Lublin, Poland.
Insights
Cardiac rehabilitation (CR) significantly reduces risk factors after acute coronary syndrome (ACS). Combining sanatorium and ambulatory programs (A + S) proved most effective for improving patient outcomes.
Area of Science:
- Cardiology
- Public Health
- Rehabilitation Medicine
Background:
- Cardiac rehabilitation (CR) is crucial for post-acute coronary syndrome (ACS) patient recovery.
- Understanding the impact of different CR modalities on risk factor management is essential.
Purpose of the Study:
- To compare the utilization of various CR forms.
- To assess the association between CR participation and risk factor reduction in ACS patients.
Main Methods:
- Retrospective analysis of 1600 ACS patients' medical records.
- Categorization into four CR groups: no rehab (0+0), sanatorium (0+S), outpatient (0+A), and combined (A+S).
- Evaluation of smoking, hypertension, and obesity risk factors; Propensity Score Matching (PSM) applied.
Main Results:
- Patients not in CR showed higher rates of smoking relapse and persistent obesity.
- Combined A+S rehabilitation was linked to higher odds of quitting smoking, reducing hypertension, and reducing obesity.
- Specific ORs highlighted significant associations, e.g., OR=11.44 for hypertension reduction with A+S.
Conclusions:
- Combined sanatorium and ambulatory CR programs (A+S) are most effective.
- This integrated approach significantly reduces key cardiovascular risk factors post-ACS.
Abstract:
Background/Objectives: Cardiac rehabilitation (CR) is the most important element in the process of returning patients to everyday functioning. The aim of the study was to compare the frequency of use of various forms of CR in terms of the occurrence of various risk factors in patients after acute coronary syndrome (ACS). Methods: The study was conducted in a group of 1600 patients after ACS across 4 time points: 3, 6, 12 months, and 5 years. Patients were classified into four groups: (1) patients who do not participate in any rehabilitation programme after hospital treatment (0 + 0); (2) patients participating in a sanatorium programme (0 + S); (3) patients participating in an outpatient programme (0 + A); (4) patients participating in both forms (A + S). The study retrospectively analysed patients' medical records for the following risk factors: smoking, hypertension, and obesity. The relationship between the four groups and the likelihood of undergoing a given form of rehabilitation was determined (Odds ratio [OR]; 95% confidence interval [CI]). Group matching in terms of gender and age was also applied using Propensity Score Matching (PSM). Results: Among those who did not undergo rehabilitation (0 + 0) 6 months after ACS, compared to the baseline groups, the most common were those who returned to smoking (OR = 3.42) and those with persistent obesity (OR = 3.69); after 5 years-individuals who reduced their obesity (OR = 4.86; after PSM: OR = 6.51). The highest chance of A + S rehabilitation was observed in the 3rd and 6th month in the group of people who quit smoking (OR = 7.60; OR = 6.04), after 6 months in the 'reduction in uncontrolled hypertension' group (OR = 11.44) and after 3 months in the 'Reduction in obesity (after PSM)' group (OR = 7.80). Conclusions: The most effective reduction in selected risk factors is reached by participation in sanatorium and ambulatory programmes (A + S).
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