Cardiac Rehabilitation Improves Outcomes After Thoracic Aortic Aneurysm Repair.
Source: PubMed, NCBI / U.S. National Library of Medicine
Cardiac rehabilitation (CR) improves prognosis in patients with ischemic heart disease and heart failure. However, its effectiveness in aortic diseases, such as thoracic aortic aneurysms (TAA), remains unclear. To evaluate the effects of outpatient CR on major adverse cardiovascular events (MACEs) and all-cause mortality after open repair surgery for TAA. This retrospective cohort study analyzed 1,710 patients who underwent open TAA repair between 2003 and 2015. Patients were divided into a CR group (n = 419) and a non-CR group (n = 1,193). Follow-up duration was 1,603 (734-2,301) days in the CR group and 1,169 (610-1,991) days in the non-CR group. Propensity score matching was used to balance the baseline characteristics. Primary outcomes were MACE and all-cause mortality. After matching, the CR group exhibited a significantly lower incidence of MACEs (HR: 0.58; 95% CI: 0.34-0.97; P = 0.039) and all-cause mortality (HR: 0.59; 95% CI: 0.37-0.94; P = 0.026). The 5-year estimated all-cause mortality rate was 7.5% (95% CI: 4.9%-11.3%) and 12.3% (95% CI: 8.7%-17.3%), respectively. Cardiovascular deaths were 1.7% (7 of 419) and 2.9% (35 of 1,193) in the CR and non-CR groups, respectively (P = 0.17). Former smoking was independently associated with higher all-cause mortality (HR: 2.69; 95% CI: 1.62-4.45; P = 0.001). In former smokers, CR was associated with lower all-cause mortality (log-rank P = 0.008). Outpatient CR following TAA surgery was associated with reduced risks of MACE
Abstract
Cardiac rehabilitation (CR) improves prognosis in patients with ischemic heart disease and heart failure. However, its effectiveness in aortic diseases, such as thoracic aortic aneurysms (TAA), remains unclear. To evaluate the effects of outpatient CR on major adverse cardiovascular events (MACEs) and all-cause mortality after open repair surgery for TAA. This retrospective cohort study analyzed 1,710 patients who underwent open TAA repair between 2003 and 2015. Patients were divided into a CR group (n = 419) and a non-CR group (n = 1,193). Follow-up duration was 1,603 (734-2,301) days in the CR group and 1,169 (610-1,991) days in the non-CR group. Propensity score matching was used to balance the baseline characteristics. Primary outcomes were MACE and all-cause mortality. After matching, the CR group exhibited a significantly lower incidence of MACEs (HR: 0.58; 95% CI: 0.34-0.97; P = 0.039) and all-cause mortality (HR: 0.59; 95% CI: 0.37-0.94; P = 0.026). The 5-year estimated all-cause mortality rate was 7.5% (95% CI: 4.9%-11.3%) and 12.3% (95% CI: 8.7%-17.3%), respectively. Cardiovascular deaths were 1.7% (7 of 419) and 2.9% (35 of 1,193) in the CR and non-CR groups, respectively (P = 0.17). Former smoking was independently associated with higher all-cause mortality (HR: 2.69; 95% CI: 1.62-4.45; P = 0.001). In former smokers, CR was associated with lower all-cause mortality (log-rank P = 0.008). Outpatient CR following TAA surgery was associated with reduced risks of MACE and all-cause mortality, even in the patients with former smoking.