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A patient-centered multidisciplinary cardiac rehabilitation program improves glycemic control and functional outcome in coronary artery disease after percutaneous and surgical revascularization

BACKGROUND: Cardiac rehabilitation (CR) is strongly associated with all-cause mortality reduction in patients with coronary artery disease (CAD). The impact of CR on pathological risk factors, such as impaired glucose tolerance (IGT) and functional recovery remains under debate. The aim of the prese...

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Autores principales: Denegri, Andrea, Rossi, Valentina A., Vaghi, Fabrizio, Di Muro, Paolo, Regazzi, Martino, Moccetti, Tiziano, Pasotti, Elena, Pedrazzini, Battista G., Capoferri, Mauro, Moccetti, Marco
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Via Medica 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8890425/
https://www.ncbi.nlm.nih.gov/pubmed/32037504
http://dx.doi.org/10.5603/CJ.a2020.0006
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author Denegri, Andrea
Rossi, Valentina A.
Vaghi, Fabrizio
Di Muro, Paolo
Regazzi, Martino
Moccetti, Tiziano
Pasotti, Elena
Pedrazzini, Battista G.
Capoferri, Mauro
Moccetti, Marco
author_facet Denegri, Andrea
Rossi, Valentina A.
Vaghi, Fabrizio
Di Muro, Paolo
Regazzi, Martino
Moccetti, Tiziano
Pasotti, Elena
Pedrazzini, Battista G.
Capoferri, Mauro
Moccetti, Marco
author_sort Denegri, Andrea
collection PubMed
description BACKGROUND: Cardiac rehabilitation (CR) is strongly associated with all-cause mortality reduction in patients with coronary artery disease (CAD). The impact of CR on pathological risk factors, such as impaired glucose tolerance (IGT) and functional recovery remains under debate. The aim of the present study is to determine whether CR had a positive effect beside physical exercise improvement on pathological risk factors in IGT and diabetic patients with CAD. METHODS: One hundred and seventy-one consecutive patients participating in a 3-month CR from January 2014 to June 2015 were enrolled. The primary endpoint was defined as an improvement of peak workload and VO2-peak; glycated hemoglobin (HbA1c) reduction was considered as secondary endpoint. RESULTS: Euglycemic patients presented a significant improvement in peak workload compared to diabetic patients (from 5.75 ± 1.45 to 6.65 ± 1.84 METs vs. 4.8 ± 0.8 to 4.9 ± 1.4 METs, p = 0.018). VO2-peak improved in euglycemic patients (VO2-peak from 19.3 ± 5.3 to 22.5 ± 5.9 mL/min/kg, p = 0.003), while diabetic patients presented only a statistically significant trend (VO2-peak from 16.9 ± 4.4 to 18.0 ± 3.8 mL/min/kg, p < 0.056). Diabetic patients have benefited more in terms of blood glucose control compared to IGT patients (HbA1c from 7.7 ± 1.0 to 7.4 ± 1.1 compared to 5.6 ± 0.4 to 5.9 ± 0.5, p = 0.02, respectively). CONCLUSIONS: A multidisciplinary CR program improves physical functional capacity in CAD setting, particularly in euglycemic patients. IGT patients as well as diabetic patients may benefit from a CR program, but long-term outcome needs to be clarified in larger studies.
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spelling pubmed-88904252022-03-03 A patient-centered multidisciplinary cardiac rehabilitation program improves glycemic control and functional outcome in coronary artery disease after percutaneous and surgical revascularization Denegri, Andrea Rossi, Valentina A. Vaghi, Fabrizio Di Muro, Paolo Regazzi, Martino Moccetti, Tiziano Pasotti, Elena Pedrazzini, Battista G. Capoferri, Mauro Moccetti, Marco Cardiol J Clinical Cardiology BACKGROUND: Cardiac rehabilitation (CR) is strongly associated with all-cause mortality reduction in patients with coronary artery disease (CAD). The impact of CR on pathological risk factors, such as impaired glucose tolerance (IGT) and functional recovery remains under debate. The aim of the present study is to determine whether CR had a positive effect beside physical exercise improvement on pathological risk factors in IGT and diabetic patients with CAD. METHODS: One hundred and seventy-one consecutive patients participating in a 3-month CR from January 2014 to June 2015 were enrolled. The primary endpoint was defined as an improvement of peak workload and VO2-peak; glycated hemoglobin (HbA1c) reduction was considered as secondary endpoint. RESULTS: Euglycemic patients presented a significant improvement in peak workload compared to diabetic patients (from 5.75 ± 1.45 to 6.65 ± 1.84 METs vs. 4.8 ± 0.8 to 4.9 ± 1.4 METs, p = 0.018). VO2-peak improved in euglycemic patients (VO2-peak from 19.3 ± 5.3 to 22.5 ± 5.9 mL/min/kg, p = 0.003), while diabetic patients presented only a statistically significant trend (VO2-peak from 16.9 ± 4.4 to 18.0 ± 3.8 mL/min/kg, p < 0.056). Diabetic patients have benefited more in terms of blood glucose control compared to IGT patients (HbA1c from 7.7 ± 1.0 to 7.4 ± 1.1 compared to 5.6 ± 0.4 to 5.9 ± 0.5, p = 0.02, respectively). CONCLUSIONS: A multidisciplinary CR program improves physical functional capacity in CAD setting, particularly in euglycemic patients. IGT patients as well as diabetic patients may benefit from a CR program, but long-term outcome needs to be clarified in larger studies. Via Medica 2022-02-23 /pmc/articles/PMC8890425/ /pubmed/32037504 http://dx.doi.org/10.5603/CJ.a2020.0006 Text en Copyright © 2022 Via Medica https://creativecommons.org/licenses/by-nc-nd/4.0/This article is available in open access under Creative Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license, allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially
spellingShingle Clinical Cardiology
Denegri, Andrea
Rossi, Valentina A.
Vaghi, Fabrizio
Di Muro, Paolo
Regazzi, Martino
Moccetti, Tiziano
Pasotti, Elena
Pedrazzini, Battista G.
Capoferri, Mauro
Moccetti, Marco
A patient-centered multidisciplinary cardiac rehabilitation program improves glycemic control and functional outcome in coronary artery disease after percutaneous and surgical revascularization
title A patient-centered multidisciplinary cardiac rehabilitation program improves glycemic control and functional outcome in coronary artery disease after percutaneous and surgical revascularization
title_full A patient-centered multidisciplinary cardiac rehabilitation program improves glycemic control and functional outcome in coronary artery disease after percutaneous and surgical revascularization
title_fullStr A patient-centered multidisciplinary cardiac rehabilitation program improves glycemic control and functional outcome in coronary artery disease after percutaneous and surgical revascularization
title_full_unstemmed A patient-centered multidisciplinary cardiac rehabilitation program improves glycemic control and functional outcome in coronary artery disease after percutaneous and surgical revascularization
title_short A patient-centered multidisciplinary cardiac rehabilitation program improves glycemic control and functional outcome in coronary artery disease after percutaneous and surgical revascularization
title_sort patient-centered multidisciplinary cardiac rehabilitation program improves glycemic control and functional outcome in coronary artery disease after percutaneous and surgical revascularization
topic Clinical Cardiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8890425/
https://www.ncbi.nlm.nih.gov/pubmed/32037504
http://dx.doi.org/10.5603/CJ.a2020.0006
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