Clinical outcomes after cardiac rehabilitation in elderly patients with and without diabetes mellitus: The EU-CaRE multicenter cohort study

Autor: Esther P. Meindersma, Ed P de Kluiver, Leonie F Prins, Uwe Zeymer, Matthias Wilhelm, Arnoud. W. J. Van’tHof, Eva Prescott, Thimo Marcin, Astrid E van der Velde, Diego Ardissino, Prisca Eser, Carlos Peña-Gil, Markus Laimer, Wendy Bruins, Marie-Christine Iliou, Evelien Kolkman
Přispěvatelé: RS: Carim - H01 Clinical atrial fibrillation, Cardiologie, MUMC+: MA Med Staf Spec Cardiologie (9)
Rok vydání: 2020
Předmět:
Male
lcsh:Diseases of the circulatory (Cardiovascular) system
Time Factors
Endocrinology
Diabetes and Metabolism
Health Status
Vascular damage Radboud Institute for Health Sciences [Radboudumc 16]
Obesity/mortality
cardiovascular-disease
Cardiac rehabilitation
030204 cardiovascular system & hematology
Coronary artery disease
0302 clinical medicine
Weight loss
Risk Factors
GLYCEMIC CONTROL
Cause of Death
Diabetes Mellitus/diagnosis
risk-factors
Cardiovascular risk factors
Original Investigation
Peak VO2
2. Zero hunger
Exercise Tolerance
PULSE PRESSURE
Age Factors
3. Good health
Europe
arterial stiffness
Treatment Outcome
Systolic blood pressure
Female
medicine.symptom
Heart Diseases/diagnosis
Cardiology and Cardiovascular Medicine
Cohort study
medicine.medical_specialty
chronotropic incompetence
HbA1c
Heart Diseases
WEIGHT-LOSS
030209 endocrinology & metabolism
610 Medicine & health
ALL-CAUSE
Risk Assessment
Europe/epidemiology
03 medical and health sciences
BMI
All institutes and research themes of the Radboud University Medical Center
Oxygen Consumption
Internal medicine
Diabetes mellitus
Weight Loss
medicine
Diabetes Mellitus
Exercise capacity
training modalities
Humans
Obesity
LDL-C
Glycemic
Aged
business.industry
Weight change
Recovery of Function
medicine.disease
Blood pressure
Cardiac Rehabilitation/adverse effects
lcsh:RC666-701
business
Body mass index
Zdroj: Cardiovascular Diabetology, 19
Cardiovascular Diabetology, Vol 19, Iss 1, Pp 1-12 (2020)
Cardiovascular Diabetology
Eser, Prisca; Marcin, Thimo; Prescott, Eva; Prins, Leonie F; Kolkman, Evelien; Bruins, Wendy; van der Velde, Astrid E; Peña-Gil, Carlos; Iliou, Marie-Christine; Ardissino, Diego; Zeymer, Uwe; Meindersma, Esther P; Van'tHof, Arnoud W J; de Kluiver, Ed P; Laimer, Markus; Wilhelm, Matthias (2020). Clinical outcomes after cardiac rehabilitation in elderly patients with and without diabetes mellitus: The EU-CaRE multicenter cohort study. Cardiovascular diabetology, 19(1), p. 37. BioMed Central 10.1186/s12933-020-01013-8
Cardiovascular Diabetology, 19(1):37. BioMed Central Ltd
Cardiovascular Diabetology, 19, 1
Eser, P, Marcin, T, Prescott, E, Prins, L F, Kolkman, E, Bruins, W, van der Velde, A E, Peña-Gil, C, Iliou, M-C, Ardissino, D, Zeymer, U, Meindersma, E P, Van'tHof, A W J, de Kluiver, E P, Laimer, M & Wilhelm, M 2020, ' Clinical outcomes after cardiac rehabilitation in elderly patients with and without diabetes mellitus : The EU-CaRE multicenter cohort study ', Cardiovascular Diabetology, vol. 19, 37 . https://doi.org/10.1186/s12933-020-01013-8
ISSN: 1475-2840
DOI: 10.1186/s12933-020-01013-8
Popis: Background The prevalence of patients with concomitant cardiovascular disease and diabetes mellitus (DM) is increasing rapidly. We aimed to compare the effectiveness of current cardiac rehabilitation (CR) programs across seven European countries between elderly cardiac patients with and without DM. Methods 1633 acute and chronic coronary artery disease (CAD) patients and patients after valve intervention with an age 65 or above who participated in comprehensive CR (3 weeks to 3 months, depending on centre) were included. Peak oxygen uptake (VO2 peak), body mass index, resting systolic blood pressure, low-density lipoprotein-cholesterol (LDL-C), and glycated haemoglobin (HbA1c) were assessed before start of CR, at termination of CR (variable time point), and 12 months after start of CR, with no intervention after CR. Baseline values and changes from baseline to 12-month follow-up were compared between patients with and without DM using mixed models, and mortality and hospitalisation rates using logistic regression. Results 430 (26.3%) patients had DM. Patients with DM had more body fat, lower educational level, more comorbidities, cardiovascular risk factors, and more advanced CAD. Both groups increased their VO2 peak over the study period but with a significantly lower improvement from baseline to follow-up in patients with DM. In the DM group, change in HbA1c was associated with weight change but not with change in absolute VO2 peak. 12-month cardiac mortality was higher in patients with DM. Conclusions While immediate improvements in VO2 peak after CR in elderly patients with and without DM were similar, 12-month maintenance of this improvement was inferior in patients with DM, possibly related to disease progression. Glycemic control was less favourable in diabetic patients needing insulin in the short- and long-term. Since glycemic control was only related to weight loss but not to increase in exercise capacity, this highlights the importance of weight loss in obese DM patients during CR. Trial registration NTR5306 at trialregister.nl; trial registered 07/16/2015; https://www.trialregister.nl/trial/5166
Databáze: OpenAIRE
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