Cardiac Rehabilitation after an Acute Coronary Syndrome: The Impact in Elderly Patients

Cardiology ◽  
2015 ◽  
Vol 131 (3) ◽  
pp. 177-185 ◽  
Author(s):  
Patrícia Rodrigues ◽  
Mário Santos ◽  
Maria João Sousa ◽  
Bruno Brochado ◽  
Diana Anjo ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Cardiac Rehabilitation ◽  
Functional Capacity ◽  
Heart Rate Recovery ◽  
Real Life ◽  
The Elderly ◽  
Chronotropic Response ◽  
Coronary Syndrome ◽  
Supervised Exercise ◽  
The Impact

Introduction: Cardiac rehabilitation (CR) has been shown to decrease mortality and morbidity, improve the control of risk factors and the quality of life of patients with coronary artery disease. However, the elderly are underrepresented in most studies and in real-life CR programs. Our goal was to evaluate the impact of CR after an acute coronary syndrome in the elderly population. Methods: A cutoff of 65 years was used to dichotomize age. Our main focus was on the effects of ambulatory supervised exercise training on several surrogate markers, namely total cholesterol, low- and high-density lipoprotein cholesterol, triglycerides, body mass index, fasting glucose, glycated hemoglobin, probrain natriuretic peptide, International Physical Activity Questionnaire score, maximal exercise capacity, chronotropic response index and heart rate recovery. We evaluated those variables at the beginning and at the end of phase II of the CR program (after 3 months) and repeated the treadmill test at 12 months. Results: A total of 548 patients with a recent acute coronary syndrome were enrolled; 37% were 65 years old or older. Both age groups had a statistically significant improvement in all the evaluated parameters. Interestingly, at 12 months both groups maintained the improvement in functional capacity seen immediately after 3 months. Conclusions: The benefits of CR in terms of functional capacity, metabolic profile and other prognostic parameters were significant in both younger and older patients. Therefore, all eligible patients should be referred to CR programs, irrespective of age.

scholarly journals Cardiac rehabilitation program after an acute coronary syndrome in the elderly population: benefits and safety

2013 ◽  
Vol 34 (suppl 1) ◽  
pp. P5806-P5806
Author(s):  
D. Gemma ◽  
S. O. Rosillo Rodriguez ◽  
F. De Torres Alba ◽  
S. Del Prado Diaz ◽  
A. M. Iniesta Manjavacas ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Cardiac Rehabilitation ◽  
Elderly Population ◽  
The Elderly ◽  
Rehabilitation Program ◽  
Cardiac Rehabilitation Program ◽  
Coronary Syndrome

scholarly journals Impact of an online cardiac rehabilitation program after an acute coronary syndrome during SARS-CoV-2 pandemic

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
A Severo Sanchez ◽  
B Rivero Santana ◽  
E Arbas Redondo ◽  
VM Juarez Olmos ◽  
D Poveda Pinedo ◽  
...  
Keyword(s):  
Health Care ◽  
Acute Coronary Syndrome ◽  
Cardiac Rehabilitation ◽  
Mediterranean Diet ◽  
Cardiovascular Health ◽  
New Technologies ◽  
Rehabilitation Program ◽  
Prevention Measures ◽  
Coronary Syndrome ◽  
The Impact

Abstract Funding Acknowledgements Type of funding sources: Public hospital(s). Main funding source(s): Hospital Universitario La Paz Introduction The SARS-CoV-2 pandemic has overloaded health care systems at several fields. Spanish COVID-19 first wave led to the interruption of most cardiac rehabilitation (CRH) programs in our country. Resume activity without compromising patient"s safety has been a challenge. At our centre (a third-level hospital), we modified our routine clinical practice from face-to-face interviews to a complete online CRH program since July 1st 2020. Purpose The aim of this study is to analyse the impact of an online CRH program after hospital discharge for an acute coronary syndrome in health goals and adherence to secondary prevention measures at the end of the program. Methods This is a retrospective study made up of patients who, after suffering an acute myocardial infarction, followed an online CRH program from June to November 2020. A first online assessment is made by a cardiology consultant. Then, it is followed by ten online group interviews of up to three patients and a health care proffesional: either a nurse or a physiotherapist. These interviews last around ninety minutes. Four weeks after, an online follow-up interview is made by a cardiology consultant. These interviews focus either on physical exercise instructions (aerobical exercise and endurance exercise) or educational interviews (ischemic cardiomyopathy, Mediterranean diet, pharmacological treatment, sexual dysfunction, stress management techniques and solution of questions). Results Up to eighty-four patients were included in our CRH program (this means 83% of patients discharged from our hospital after an acute coronary event). Median of time from discharge to first online interview was 8"79 days and from this last one to program beginning, 3"67 days. Four weeks after the beginning of the program, 82% of the patients presented with a LDL-cholesterol level below aim level (< 55 mg/dL). Workout, Mediterranean diet and tobacco abstinence observance rates were over 90%. There were just three patients who gave up or did not complete the program. Conclusion Despite the fact that SARS-CoV-2 pandemic has arisen a huge challenge for ongoing CRH programs in Spain, the benefit that has been showed by them on cardiovascular health, makes it necessary to develop new tools to allow them going on. New technologies are an opportunity for us to keep on following these patients, moreover showing good results as for adherence, availability and patient and operator assesssment.

The Impact of Short-term Cardiac Rehabilitation on Changing Dietary Habits in Patients After Acute Coronary Syndrome

2013 ◽  
Vol 33 (4) ◽  
pp. 234-238 ◽  
Author(s):  
Slawomira Borowicz-Bienkowska ◽  
Ewa Deskur-Smielecka ◽  
Maria Maleszka ◽  
Izabela Przywarska ◽  
Malgorzata Wilk ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Cardiac Rehabilitation ◽  
Dietary Habits ◽  
Short Term ◽  
Coronary Syndrome ◽  
The Impact

Heart rate recovery of individuals undergoing cardiac rehabilitation after acute coronary syndrome

2018 ◽  
Vol 61 (2) ◽  
pp. 65-71
Author(s):  
Tiffany Astolfi ◽  
Fabio Borrani ◽  
Milos Savcic ◽  
Vincent Gremeaux ◽  
Grégoire P. Millet
Keyword(s):  
Heart Rate ◽  
Acute Coronary Syndrome ◽  
Cardiac Rehabilitation ◽  
Heart Rate Recovery ◽  
Coronary Syndrome

scholarly journals Sex Differences in the Outcomes of Elderly Patients with Acute Coronary Syndrome

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Shi Tai ◽  
Xuping Li ◽  
Hui Yang ◽  
Zhaowei Zhu ◽  
Liang Tang ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Mortality Rate ◽  
Elderly Patients ◽  
Protective Factor ◽  
Multivariable Analysis ◽  
The Elderly ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment ◽  
The Impact

Background. The impact of sex on the outcome of patients with acute coronary syndrome (ACS) has been suggested, but little is known about its impact on elderly patients with ACS. Methods. This study analyzed the impact of sex on in-hospital and 1-year outcomes of elderly (≥75 years of age) patients with ACS hospitalized in our department between January 2013 and December 2017. Results. A total of 711 patients were included: 273 (38.4%) women and 438 (61.6%) men. Their age ranged from 75 to 94 years, similar between women and men. Women had more comorbidities (hypertension (79.5% vs. 72.8%, p=0.050), diabetes mellitus (35.2% vs. 26.5%, p=0.014), and hyperuricemia (39.9% vs. 32.4%, p=0.042)) and had a higher prevalence of non-ST-segment elevation ACS (NSTE-ACS) (79.5% vs. 71.2%, p=0.014) than men. The prevalence of current smoking (56.5% vs. 5.4%, p<0.001), creatinine levels (124.4 ± 98.6 vs. 89.9 ± 54.1, p<0.001), and revascularization rate (39.7% vs. 30.0%, p=0.022) were higher, and troponin TnT and NT-proBNP tended to be higher in men than in women. The in-hospital mortality rate was similar (3.5% vs. 4.4%, p=0.693), but the 1-year mortality rate was lower in women than in men (14.7% vs. 21.7%, p=0.020). The multivariable analysis showed that female sex was a protective factor for 1-year mortality in all patients (OR = 0.565, 95% CI 0.351–0.908, p=0.018) and in patients with STEMI (OR = 0.416, 95% CI 0.184–0.940, p=0.035) after adjustment. Conclusions. Among the elderly patients with ACS, the 1-year mortality rate was lower in women than in men, which could be associated with comorbidities and ACS type.

scholarly journals Effect of Age on Clinical Presentation and Outcome of Patients Hospitalized with Acute Coronary Syndrome: A 20-Year Registry in a Middle Eastern Country

2012 ◽  
Vol 6 (1) ◽  
pp. 60-67 ◽  
Author(s):  
Emad Ahmed ◽  
Ayman El-Menyar ◽  
Rajvir Singh ◽  
Hajar A Al Binali1 ◽  
Jassim Al Suwaidi
Keyword(s):  
Acute Coronary Syndrome ◽  
Older Patients ◽  
Middle Eastern ◽  
The Elderly ◽  
Relative Reduction ◽  
Evidence Based ◽  
Term Outcome ◽  
Coronary Syndrome ◽  
Clinical Registries ◽  
The Impact

Introduction: Despite the fact that the elderly constitute an increasingly important group of patients with acute coronary syndrome (ACS), they are often excluded from clinical trials and are underrepresented in clinical registries. Aims: To evaluate the impact of age in patients hospitalized with ACS. Methods: Data collected for all patients presenting with ACS (n=16,744) who were admitted in Qatar during the period (1991-2010) and were analyzed according to age into 3 groups (≤50 years [41.4%], 51-70 years [48.7%] and >70 years [9.8%]). Results: Older patients were more likely to be women and have hypertension, diabetes mellitus, and renal failure, while younger patients were more likely to be smokers. Non-ST-elevation myocardial infarction and heart failure were more prevalent in older patients. Older age was associated with undertreatment with evidence-based therapies and had higher mortality rate. Age was independent predictor for mortality. Over the study period, the relative reduction in mortality rates was higher in the younger compared with the older patients (61, 45.9 and 35.5%). Conclusions: Despite being a higher-risk group, older patients were undertreated with evidence based therapy and had worse short-term outcome. Guidelines adherence and improvement in hospital care for elderly patients with ACS may potentially reduce morbidity and mortality.

scholarly journals Cardiac Rehabilitation and Complementary Physical Training in Elderly Patients after Acute Coronary Syndrome: A Pilot Study

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 529
Author(s):  
Aurelija Beigienė ◽  
Daiva Petruševičienė ◽  
Vitalija Barasaitė ◽  
Raimondas Kubilius ◽  
Jūratė Macijauskienė
Keyword(s):  
Acute Coronary Syndrome ◽  
Muscle Strength ◽  
Elderly Patients ◽  
Cardiac Rehabilitation ◽  
Physical Performance ◽  
Functional Capacity ◽  
Training Programs ◽  
Balance Training ◽  
Coronary Syndrome ◽  
Minute Walk

Background and Objectives: Nearly 23% of elderly patients hospitalized due to acute coronary syndrome have reduced muscle strength. It is assumed that these patients would better benefit from a complex training—a combination of endurance, strength, balance, coordination, and flexibility—in order to reduce the loss of muscle strength and mass and improve functional capacity. The aim of this study was to assess the effectiveness and safety of two different complementary resistance and balance training programs during short-term cardiac rehabilitation (CR) in elderly patients after a percutaneous or surgical intervention due to acute coronary syndrome. Materials and Methods: This randomized controlled trial was conducted from January 2020 to February 2021 in one Lithuanian rehabilitation hospital. A total of 63 participants who met the inclusion criteria were randomly assigned to three groups (at the ratio of 1:1:1): control (CG, n = 19), intervention 1 (IG-1, n = 26), and intervention 2 (IG-2, n = 18). All the patients attended a usual inpatient CR program of a mean duration of 18.7 ± 1.7 days, while the patients assigned to the intervention groups (IG-1 and IG-2) additionally received different resistance and balance training programs three days a week. Functional capacity, with 6-minute walk test (6MWT) and cardiopulmonary exercise testing (CPET), as well as physical performance, with the short physical performance battery (SPPB) test and one repetition maximum test (1RM) for leg press, were assessed at baseline and after CR. Results: The mean age of the participants was 72.9 ± 5.5 years; 73% were men. All parameters of functional capacity and physical performance improved significantly after CR (p < 0.05), except for peak VO2 that improved only in the IG-1. Comparison of CR effectiveness among the groups revealed no significant differences. Conclusions: All three rehabilitation programs were safe and well tolerated by elderly patients aged ≥65 years as well as improved functional capacity (6-minute walk distance and peak workload) and physical performance (SPPB and 1RM). Complementary resistance and balance training with traditional physical therapy means and exercises with mechanical devices did not show greater benefits for the results of physical performance compared with the usual CR program.

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