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Cardiac Rehabilitation After Acute Coronary Syndrome: Do All Patients Derive the Same Benefit?

2017-03Journal article Open access
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dc.contributor.authorAguiar Rosa, S
dc.contributor.authorAbreu, A
dc.contributor.authorMarques Soares, R
dc.contributor.authorRio, P
dc.contributor.authorFilipe, C
dc.contributor.authorRodrigues, I
dc.contributor.authorMonteiro, A
dc.contributor.authorSoares, C
dc.contributor.authorFerreira, V
dc.contributor.authorSilva, S
dc.contributor.authorAlves, S
dc.contributor.authorCruz Ferreira, R
dc.date.accessioned2018-07-09T14:33:43Z
dc.date.available2018-07-09T14:33:43Z
dc.date.issued2017-03
dc.description.abstractINTRODUCTION: Cardiac rehabilitation (CR) has been demonstrated to improve exercise capacity in acute coronary syndrome (ACS), but not all patients derive the same benefit. Careful patient selection is crucial to maximize resources. OBJECTIVE: To identify in a heterogeneous ACS population which patients would benefit the most with CR, in terms of functional capacity (FC), by using cardiopulmonary exercise testing (CPET). METHODS: A retrospective analysis of consecutive ACS patients who underwent CR and CPET was undertaken. CPET was performed at baseline and after 36 sessions of exercise. Peak oxygen uptake (pVO2), percentage of predicted pVO2, minute ventilation/CO2 production (VE/VCO2) slope, VE/VCO2 slope/pVO2 and peak circulatory power (PCP) (pVO2 times peak systolic blood pressure) were assessed in two moments. The differences in pVO2 (ΔpVO2), %pVO2, PCP and exercise test duration were calculated. Patients were classified according to baseline pVO2 (group 1, <20 ml/kg/min vs. group 2, ≥20 ml/kg/min) and left ventricular ejection fraction (group A, <50% vs. group B, ≥50%). RESULTS: We analyzed 129 patients, 86% male, mean age 56.3±9.8 years. Both group 1 (n=31) and group 2 (n=98) showed significant improvement in FC after CR, with a more significant increase in pVO2, in group 1 (ΔpVO2 4.4±7.3 vs. 1.6±5.4; p=0.018). Significant improvement was observed in CPET parameters in group A (n=34) and group B (n=95), particularly in pVO2 and test duration. CONCLUSION: Patients with lower baseline pVO2 (<20 ml/kg/min) presented more significant improvement in FC after CR. CPET which is not routinely used in assessement before CR in context of ACS, could be a valuable tool to identify patients who will benefit the most.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationRev Port Cardiol. 2017 Mar;36(3):169-176.pt_PT
dc.identifier.doi10.1016/j.repc.2016.09.011pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/3002
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevier Españapt_PT
dc.subjectAcute Coronary Syndromept_PT
dc.subjectExercise Testpt_PT
dc.subjectFemalept_PT
dc.subjectHumanspt_PT
dc.subjectMalept_PT
dc.subjectMiddle Agedpt_PT
dc.subjectPatient Selectionpt_PT
dc.subjectRetrospective Studiespt_PT
dc.subjectTreatment Outcomept_PT
dc.subjectCardiac Rehabilitationpt_PT
dc.subjectHSM CARpt_PT
dc.titleCardiac Rehabilitation After Acute Coronary Syndrome: Do All Patients Derive the Same Benefit?pt_PT
dc.title.alternativeReabilitação Cardíaca Após Síndrome Coronária Aguda: Terão Todos os Doentes o Mesmo Benefício?pt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage176pt_PT
oaire.citation.issue3pt_PT
oaire.citation.startPage169pt_PT
oaire.citation.titleRevista Portuguesa de Cardiologiapt_PT
oaire.citation.volume36pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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