Determinants of Functional Improvement After Cardiac Rehabilitation in Acute Coronary Syndrome

High Blood Press Cardiovasc Prev. 2021 Nov;28(6):579-587. doi: 10.1007/s40292-021-00473-7. Epub 2021 Sep 13.

Abstract

Introduction: Cardiac rehabilitation (CR) is an effective tool for secondary prevention after acute coronary syndrome (ACS).

Aim: Aim of our study was to find the significant determinants of exercise capacity (evaluated with the six-minute walking test-6-MWT) and functional improvement in patients undergoing CR after an ACS.

Methods: The study group included 298 patients (mean age 61.6 ± 10.2 years; males 80.2%) who, after ACS, were enrolled in CR program at Niguarda Hospital in Milan from 2015 to 2018. For all patients, we collected anamnestic, clinical and instrumental cardiological data. All patients performed a 6-MWT at the beginning (6-MWT-1) and at the end (6-MWT-2) of CR program. Δ meters were used to represent functional improvement.

Results: Multiple linear regression models were carried out for 6-MWT-1, 6-MWT-2, Δ meters and % Δ meters. Standardized regression coefficients showed that age (β = - 0.237; p < 0.001), BMI (β = - 0.116; p = 0.006) and heart rate (β = - 0.082; p = 0.040) were determinants of exercise capacity (6MWT-1 and 2), whereas age (β = -.231; p = 0.004), sex (β = - 0.187; p = 0.008) and BMI (β = - 0.164; p = 0.022) were determinants of functional improvement (Δ meters).

Conclusions: Our data showed that functional improvement after CR in ACS patients is mainly related to non-cardiological variables. Instead it is related to intrinsic factors, both modifiable (BMI) and non-modifiable (age, sex).

Keywords: Acute coronary syndrome; Cardiac rehabilitation; Functional improvement.

MeSH terms

  • Acute Coronary Syndrome* / physiopathology
  • Acute Coronary Syndrome* / rehabilitation
  • Aged
  • Cardiac Rehabilitation*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Physical Functional Performance*
  • Treatment Outcome