Effectiveness of Cardiac Rehabilitation in Exercise Capacity Increase in Patients with ST-Segment Elevation Myocardial Infarction
Abstract
:1. Introduction
2. Materials and Methods
- age 40–75 years, after ST-segment elevation myocardial infarction treated with invasive procedures (after complete revascularization) who participated in post-infarct rehabilitation programme,
- BMI ≤40 kg/m2,
- ECG record with determined EF value,
- controlled arterial hypertension (baseline blood pressure in exercise test ≤ 140/90 mmHg),
- no anemia (Hb ≥ 11 g%),
- no pulmonary comorbidities (asthma, acute chronic obstructive pulmonary disease (COPD)),
- a minimum 3-week hospitalization at the cardiac rehabilitation department with exercise ECG test or the 6-min walk test performed at least twice (prior to and after rehabilitation).
3. Results
3.1. Gender
3.2. Age
3.3. BMI
3.4. EF
3.5. Diabetes
3.6. Nicotine Dependence
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Parameters | n | Gender | Age (years) | BMI (kg/m2) | EF (%) | D+ (n) | N+ (n) | ECGST (n) | 6MWT (n) | ||
---|---|---|---|---|---|---|---|---|---|---|---|
Women | Men | ||||||||||
Population | 100 | 40 | 60 | 58.3 ± 7.8 | 28.6 ± 4.9 | 45.9 ±11.0 | 40 | 48 | 59 | 41 | |
Gender | Women | 40 | 40 | 0 | 58.6 ± 7.2 | 28.3 ± 5.7 | 50.4 ±7.2 | 16 | 19 | 27 | 13 |
Men | 60 | 0 | 60 | 58.1 ± 8.2 | 28.8 ± 4.3 | 42.9 ± 12.1 | 24 | 29 | 32 | 28 | |
Age (years) | ≤55 | 34 | 13 | 21 | 49.4 ± 4.3 | 28.8 ± 5.0 | 47.4 ± 9.1 | 14 | 22 | 27 | 7 |
>55 | 66 | 27 | 39 | 62.9 ± 4.6 | 28.5 ± 4.9 | 45.2 ± 11.9 | 26 | 26 | 32 | 34 | |
BMI (kg/m2) | <25 | 20 | 11 | 9 | 57.8 ± 7.1 | 22.4 ± 1.7 | 45.9 ± 11.0 | 2 | 16 | 14 | 6 |
≥25 | 80 | 29 | 51 | 58.4 ± 8.0 | 30.2 ± 4.1 | 45.9 ± 11.1 | 38 | 32 | 45 | 35 | |
EF (%) | <40 | 26 | 3 | 23 | 61.5 ± 7.2 | 28.9 ± 4.8 | 31.0 ± 5.4 | 13 | 13 | 0 | 26 |
40–49 | 31 | 14 | 17 | 56.8 ± 8.4 | 28.1 ± 5.5 | 44.7 ± 2.9 | 11 | 16 | 23 | 8 | |
≥50 | 43 | 23 | 20 | 57.4 ± 7.2 | 28.8 ± 4.5 | 55.8 ± 5.0 | 16 | 19 | 36 | 7 | |
Diabetes (n) | D+ | 40 | 16 | 24 | 59.3 ± 7.7 | 30.0 ± 4.5 | 44.8 ± 10.1 | 40 | 16 | 19 | 21 |
D− | 60 | 24 | 36 | 57.6 ± 7.8 | 27.7 ± 4.9 | 46.6 ± 11.7 | 0 | 32 | 40 | 20 | |
Nicotinism (n) | N+ | 48 | 19 | 29 | 56.2 ± 7.6 | 27.8 ± 5.3 | 45.4 ± 10.8 | 16 | 48 | 30 | 18 |
N− | 52 | 21 | 31 | 60.2 ± 7.5 | 29.4 ± 4.4 | 46.4 ± 11.3 | 24 | 0 | 29 | 23 |
ECGST | n | Gender | Age (years) | BMI (kg/m2) | EF (%) | D+ (n) | N+ (n) | Before (MET) | After (MET) | Diff (MET) | p-Value | ||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Women | Men | ||||||||||||
Population | 59 | 27 | 32 | 55.9 ± 7.8 | 28.1 ± 4.6 | 51.7 ± 7.2 | 19 | 30 | 7.2 ± 2.0 | 8.2 ± 1.9 | 1.0 | <0.001 | |
Gender | Women | 27 | 27 | 0 | 56.5 ±7.0 | 27.3 ± 5.2 | 51.9 ± 6.7 | 8 | 15 | 6.3 ± 1.7 | 7.0 ± 1.7 | 0.7 | 0.003 |
Men | 32 | 0 | 32 | 55.4 ± 8.5 | 28.9 ± 4.0 | 51.6 ± 7.7 | 11 | 15 | 8.0 ± 1.8 | 9.2 ± 1.4 | 1.2 | <0.001 | |
Age (years) | ≤55 | 27 | 11 | 16 | 48.7 ± 4.4 | 28.4 ± 4.7 | 49.9 ± 7.0 | 7 | 18 | 7.2 ± 2.2 | 8.4 ± 2.0 | 1.2 | <0.001 |
>55 | 32 | 16 | 16 | 61.9 ± 3.8 | 27.9 ± 4.5 | 53.3 ± 7.1 | 12 | 12 | 7.2 ± 1.7 | 8.0 ± 1.8 | 0.8 | 0.002 | |
BMI (kg/m2) | <25 | 14 | 10 | 4 | 56.0 ± 7.2 | 22.4 ± 1.7 | 50.8 ± 7.9 | 2 | 11 | 7.5 ± 1.7 | 7.9 ± 1.7 | 0.4 | 0.126 |
≥25 | 45 | 17 | 28 | 55.9 ± 8.0 | 29.9 ± 3.7 | 52.0 ± 7.0 | 17 | 19 | 7.1 ± 2.1 | 8.3 ± 2.0 | 1.2 | <0.001 | |
EF (%) | <40 | 0 | - | - | - | - | - | - | - | - | - | - | - |
40–49 | 23 | 10 | 13 | 54.4 ± 8.0 | 27.5 ± 4.9 | 44.5 ± 3.0 | 7 | 13 | 6.8 ± 2.0 | 8.2 ± 1.8 | 1.4 | <0.001 | |
≥50 | 36 | 17 | 19 | 56.9 ± 7.6 | 28.6 ± 4.5 | 56.3 ± 5.0 | 12 | 17 | 7.5 ± 1.9 | 8.2 ± 2.0 | 0.7 | 0.002 | |
Diabetes (n) | D+ | 19 | 8 | 11 | 56.9 ± 7.1 | 29.2 ± 4.7 | 51.5 ± 6.2 | 19 | 8 | 7.2 ± 2.0 | 7.7 ± 2.2 | 0.5 | 0.065 |
D− | 40 | 19 | 21 | 55.4 ± 8.1 | 27.6 ± 4.5 | 51.8 ± 7.7 | 0 | 22 | 7.2 ± 2.0 | 8.4 ± 1.7 | 1.2 | <0.001 | |
Nicotinism (n) | N+ | 30 | 15 | 15 | 54.2 ± 7.8 | 27.4 ± 4.6 | 51.0 ± 7.4 | 8 | 30 | 7.0 ± 1.9 | 8.2 ± 1.7 | 1.2 | <0.001 |
N− | 29 | 12 | 17 | 57.6 ± 7.4 | 28.9 ± 4.6 | 52.4 ± 7.0 | 11 | 0 | 7.5 ± 2.0 | 8.2 ± 2.1 | 0.7 | 0.008 |
6MWT | n | Gender | Age (years) | BMI (kg/m2) | EF (%) | D+ (n) | N+ (n) | Before (m) | After (m) | Diff (m) | p-Value | ||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Women | Men | ||||||||||||
Population | 41 | 13 | 28 | 61.8 ± 6.5 | 29.3 ± 5.2 | 37.5 ± 10.2 | 21 | 18 | 380.2 ± 95.9 | 455.6 ± 103.5 | 75.4 | <0.001 | |
Gender | Women | 13 | 13 | 0 | 62.9 ± 5.9 | 30.5 ± 6.2 | 47.4 ± 7.6 | 8 | 4 | 330.3 ± 91.6 | 387.1 ± 74.8 | 56.8 | 0.023 |
Men | 28 | 0 | 28 | 61.2 ± 6.8 | 28.8 ± 4.7 | 33.0 ± 7.8 | 13 | 14 | 403.3 ± 90.2 | 487.4 ± 100.4 | 84.1 | <0.001 | |
Age (years) | ≤55 | 7 | 2 | 5 | 52.1 ± 2.9 | 30.3 ± 6.0 | 37.7 ± 10.5 | 7 | 4 | 352.1 ± 132.0 | 469.4 ± 141.7 | 117.3 | 0.016 |
>55 | 34 | 11 | 23 | 63.7 ± 5.1 | 29.1 ± 5.1 | 37.5 ± 10.3 | 14 | 14 | 385.9 ± 88.1 | 452.7 ± 96.4 | 66.8 | <0.001 | |
BMI (kg/m2) | <25 | 6 | 1 | 5 | 61.8 ± 5.2 | 22.2 ± 1.8 | 34.5 ± 8.6 | 0 | 5 | 457.7 ± 41.8 | 543.7 ± 25.8 | 86.0 | 0.031 |
≥25 | 35 | 12 | 23 | 61.7 ± 6.7 | 30.5 ± 4.6 | 38.1 ± 10.5 | 21 | 13 | 366.9 ± 96.5 | 440.5 ± 104.4 | 73.6 | <0.001 | |
EF (%) | <40 | 26 | 3 | 23 | 61.5 ± 7.2 | 28.9 ± 4.8 | 31.0 ± 5.4 | 13 | 13 | 384.7 ± 94.2 | 465.3 ± 104.2 | 80.6 | <0.001 |
40–49 | 8 | 4 | 4 | 63.8 ± 5.4 | 29.9 ± 7.1 | 45.4 ± 2.4 | 4 | 3 | 396.5 ± 68.0 | 463.1 ± 84.6 | 66.6 | 0.022 | |
≥50 | 7 | 6 | 1 | 60.3 ± 4.7 | 30.1 ± 4.9 | 53.0 ± 4.4 | 4 | 2 | 344.9 ± 130.5 | 410.6 ± 122.3 | 65.7 | 0.297 | |
Diabetes (n) | D+ | 21 | 8 | 13 | 61.5 ± 7.7 | 30.7 ± 4.4 | 38.8 ± 9.0 | 21 | 8 | 350.3 ± 95.7 | 437.1 ± 99.3 | 86.8 | <0.001 |
D− | 20 | 5 | 15 | 62.0 ± 5.1 | 27.9 ± 5.7 | 36.2 ± 11.4 | 0 | 10 | 411.5 ± 87.7 | 474.9 ± 106.8 | 63.4 | <0.001 | |
Nicotinism (n) | N+ | 18 | 4 | 14 | 59.4 ± 6.1 | 28.6 ± 6.4 | 35.9 ± 8.8 | 8 | 18 | 396.9 ± 73.3 | 474.4 ± 103.7 | 77.5 | <0.001 |
N− | 23 | 9 | 14 | 63.6 ± 6.3 | 29.9 ± 4.1 | 38.8 ± 11.2 | 13 | 0 | 367.0 ± 110.2 | 440.8 ± 103.2 | 73.8 | <0.001 |
Examined Groups | ECGST | 6MWT |
---|---|---|
Gender (Women, Men) | no differences, p = 0.293 | no differences, p = 0.223 |
Age (years) (≤55, >55) | no differences, p = 0.166 | no differences, p = 0.232 |
BMI (kg/m2) (<25, ≥25) | no differences, p = 0.170 | no differences, p = 0.406 |
EF (%) (<40, 40–49) | not enough data | no differences, p = 0.776 |
EF (%) (<40, ≥50) | not enough data | no differences, p = 0.567 |
EF (%) (40–49, ≥50) | no differences, p = 0.101 | no differences, p = 0.772 |
Diabetes (D+, D−) | no differences, p = 0.110 | no differences, p = 0.404 |
Nicotinism (N+, N−) | no differences, p = 0.172 | no differences, p = 0.916 |
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Kasperowicz, A.; Cymerys, M.; Kasperowicz, T. Effectiveness of Cardiac Rehabilitation in Exercise Capacity Increase in Patients with ST-Segment Elevation Myocardial Infarction. Int. J. Environ. Res. Public Health 2019, 16, 4085. https://doi.org/10.3390/ijerph16214085
Kasperowicz A, Cymerys M, Kasperowicz T. Effectiveness of Cardiac Rehabilitation in Exercise Capacity Increase in Patients with ST-Segment Elevation Myocardial Infarction. International Journal of Environmental Research and Public Health. 2019; 16(21):4085. https://doi.org/10.3390/ijerph16214085
Chicago/Turabian StyleKasperowicz, Anna, Maciej Cymerys, and Tomasz Kasperowicz. 2019. "Effectiveness of Cardiac Rehabilitation in Exercise Capacity Increase in Patients with ST-Segment Elevation Myocardial Infarction" International Journal of Environmental Research and Public Health 16, no. 21: 4085. https://doi.org/10.3390/ijerph16214085