On November 11, 2011, the findings from a large retrospective cohort study demonstrating impressive results of exercise-based cardiac rehabilitation (CR) in chronic coronary syndromes (CCS) were published in the European Journal of Preventive Cardiology.
This retrospective cohort study was conducted in March 2021. An online, real-world dataset of CCS patients was acquired, utilizing anonymized data from TriNetX, a global federated health research network with access to electronical medical records from numerous healthcare organizations predominantly in the USA. Patients with CCS who received percutaneous coronary interventions (PCI) were first compared with patients who were prescribed exercise-based CR. Second, patients who received both CR + PCI were compared with the CR alone group. For both comparisons, patients were propensity-score matched by age, sex, race, comorbidities, medications, and procedures. The investigators ascertained 18-month incidence of all-cause mortality, rehospitalization, and cardiovascular comorbidity [stroke, acute myocardial infarction (AMI), and new-onset heart failure].
The initial cohort consisted of 18 383 CCS patients. Following propensity score matching, exercise-based CR was associated with significantly lower odds of all-cause mortality [0.37 (95% confidence interval (CI): 0.29–0.47)], rehospitalization [0.29 (95% CI: 0.27–0.32)], and cardiovascular morbidities, compared to PCI. Subsequently, patients that received both CR + PCI did not have significantly different odds for all-cause mortality [1.00 (95% CI: 0.63–1.60)], rehospitalization [1.00 (95% CI: 0.82–1.23)], AMI [1.11 (95% CI: 0.68–1.81)], and stroke [0.71 (95% CI: 0.39–1.31)], compared to CR only. Combining PCI and exercise-based CR associated with better results with regards to incident heart failure only [1.61 (95% CI: 1.15-2.25)].
Reference: https://academic.oup.com/eurjpc/advance-article-abstract/doi/10.1093/eurjpc/zwab191/6425626
