TY - JOUR
T1 - Cardiac rehabilitation in the elderly patient in eight rehabilitation units in Western Europe
T2 - Baseline data from the EU-CaRE multicentre observational study
AU - Prescott, Eva
AU - Mikkelsen, Nicolai
AU - Holdgaard, Annette
AU - Eser, Prisca
AU - Marcin, Thimo
AU - Wilhelm, Matthias
AU - Gil, Carlos Peña
AU - González-Juanatey, José R
AU - Moatemri, Feriel
AU - Iliou, Marie Christine
AU - Schneider, Steffen
AU - Schromm, Eike
AU - Zeymer, Uwe
AU - Meindersma, Esther P
AU - Ardissino, Diego
AU - Kolkman, Evelien K
AU - Prins, Leonie F
AU - van der Velde, Astrid E
AU - Van 't Hof, Arnoud Wj
AU - de Kluiver, Ed P
N1 - Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: this project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement number 634439 and from the Swiss State Secretariat for Education, Research and Innovation for the Swiss consortium partner.
Publisher Copyright:
© The European Society of Cardiology 2019.
PY - 2019/7
Y1 - 2019/7
N2 - BACKGROUND: Due to the progressive deconditioning, comorbidities and higher complication rates, elderly patients are in particular need of cardiac rehabilitation. We compared elderly patients (65+ years old) participating in cardiac rehabilitation, focusing on baseline characteristics, risk factor control and functional assessment.METHODS: The EU-CaRE study is a prospective study comparing cardiac rehabilitation in eight centres across Western Europe. Consecutive patients with acute coronary syndrome, stable coronary artery disease and heart valve replacement undergoing cardiac rehabilitation were included.RESULTS: Of 1633 patients (median age 72 years) participating, 54% had acute coronary syndrome, 33% had stable coronary artery disease and 13% followed valve replacement. Fifty-five per cent had undergone percutaneous coronary intervention and 29% coronary artery bypass grafting. Characteristics varied across centres: 23% (17-27%) were women, 4% (0-12%) were of non-European origin and 16% (4-32%) were living alone. Median time from index event to start of cardiac rehabilitation varied from 11 to 49 days (p < 0.001). Mean VO2peak was relatively low (16 mL/kg per min) and varied significantly between the participating centres, largely unaffected by multivariable adjustment. Overall patients received guideline recommended treatment: 93% (87-97%) were on a statin and 70% (55-85%) an angiotensin-converting enzyme inhibitor/angiotensin receptor blocker. However, risk factor control was inadequate: 58% had three or more risk factors not controlled.CONCLUSION: EU-CaRE provides a snapshot of the elderly population with heart disease participating in cardiac rehabilitation across countries in Western Europe. Risk factors and exercise capacity indicate the continued need for cardiac rehabilitation in these patients. Of concern, the lag-time to start of cardiac rehabilitation needs improvement in many centres.
AB - BACKGROUND: Due to the progressive deconditioning, comorbidities and higher complication rates, elderly patients are in particular need of cardiac rehabilitation. We compared elderly patients (65+ years old) participating in cardiac rehabilitation, focusing on baseline characteristics, risk factor control and functional assessment.METHODS: The EU-CaRE study is a prospective study comparing cardiac rehabilitation in eight centres across Western Europe. Consecutive patients with acute coronary syndrome, stable coronary artery disease and heart valve replacement undergoing cardiac rehabilitation were included.RESULTS: Of 1633 patients (median age 72 years) participating, 54% had acute coronary syndrome, 33% had stable coronary artery disease and 13% followed valve replacement. Fifty-five per cent had undergone percutaneous coronary intervention and 29% coronary artery bypass grafting. Characteristics varied across centres: 23% (17-27%) were women, 4% (0-12%) were of non-European origin and 16% (4-32%) were living alone. Median time from index event to start of cardiac rehabilitation varied from 11 to 49 days (p < 0.001). Mean VO2peak was relatively low (16 mL/kg per min) and varied significantly between the participating centres, largely unaffected by multivariable adjustment. Overall patients received guideline recommended treatment: 93% (87-97%) were on a statin and 70% (55-85%) an angiotensin-converting enzyme inhibitor/angiotensin receptor blocker. However, risk factor control was inadequate: 58% had three or more risk factors not controlled.CONCLUSION: EU-CaRE provides a snapshot of the elderly population with heart disease participating in cardiac rehabilitation across countries in Western Europe. Risk factors and exercise capacity indicate the continued need for cardiac rehabilitation in these patients. Of concern, the lag-time to start of cardiac rehabilitation needs improvement in many centres.
KW - Elderly
KW - coronary heart disease
KW - heart valve replacement
KW - cardiorespiratory fitness
KW - SECONDARY PREVENTION
KW - OLDER
KW - MEN
U2 - 10.1177/2047487319839819
DO - 10.1177/2047487319839819
M3 - Article
C2 - 30924688
SN - 2047-4873
VL - 26
SP - 1052
EP - 1063
JO - European Journal of Preventive Cardiology
JF - European Journal of Preventive Cardiology
IS - 10
ER -