Prognostic effects of cardiac rehabilitation in heart failure patients classified according to physical frailty: A propensity score–matched analysis of a nationwide prospective cohort study
Background: Research regarding cardiac rehabilitation (CR) in the prognosis of heart failure (HF) patients and frailty remains lacking. Here, the effects of CR on the 2-year prognosis of HF patients were examined according to their frailty status. Methods: This multicenter prospective cohort study e...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-06-01
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| Series: | International Journal of Cardiology. Cardiovascular Risk and Prevention |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772487523000107 |
| _version_ | 1827943648232210432 |
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| author | Takuji Adachi Naoki Iritani Kuniyasu Kamiya Kotaro Iwatsu Kenta Kamisaka Yuki Iida Sumio Yamada |
| author_facet | Takuji Adachi Naoki Iritani Kuniyasu Kamiya Kotaro Iwatsu Kenta Kamisaka Yuki Iida Sumio Yamada |
| author_sort | Takuji Adachi |
| collection | DOAJ |
| description | Background: Research regarding cardiac rehabilitation (CR) in the prognosis of heart failure (HF) patients and frailty remains lacking. Here, the effects of CR on the 2-year prognosis of HF patients were examined according to their frailty status. Methods: This multicenter prospective cohort study enrolled patients hospitalized for HF. Patients who underwent ≥1 session per 2 weeks of CR within 3 months after discharge were categorized in the CR group. Patients were divided in a non-frailty (≤8 points) and physical frailty group (≥9 points) based on their FLAGSHIP frailty score. The score is based on HF prognosis, with a higher score indicating worsened physical frailty. A propensity score-matched analysis was performed to compare survival rates between the two groups according to their physical frailty status. Endpoints included HF re-hospitalization and all-cause mortality during a 2-year follow-up period. Results: Of 2697 patients included in the analysis, 285 and 95 matched pairs were distributed in the non-frailty and physical frailty groups, respectively, after propensity-score matching. CR was associated with lower incidence of HF rehospitalization in both non-frailty (hazard ratio 0.65; 95% confidence interval 0.44–0.96; p = 0.032) and physical frailty (0.54; 0.32–0.90; p = 0.019) groups. CR was not associated with all-cause mortality in either group (log-rank test, p > 0.05). Conclusion: These findings suggest the effects of CR on reduced HF rehospitalization, regardless of physical frailty status. |
| first_indexed | 2024-03-13T10:18:34Z |
| format | Article |
| id | doaj.art-313767c3a5444da191e9159c4b2e205e |
| institution | Directory Open Access Journal |
| issn | 2772-4875 |
| language | English |
| last_indexed | 2024-03-13T10:18:34Z |
| publishDate | 2023-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Cardiology. Cardiovascular Risk and Prevention |
| spelling | doaj.art-313767c3a5444da191e9159c4b2e205e2023-05-21T04:36:04ZengElsevierInternational Journal of Cardiology. Cardiovascular Risk and Prevention2772-48752023-06-0117200177Prognostic effects of cardiac rehabilitation in heart failure patients classified according to physical frailty: A propensity score–matched analysis of a nationwide prospective cohort studyTakuji Adachi0Naoki Iritani1Kuniyasu Kamiya2Kotaro Iwatsu3Kenta Kamisaka4Yuki Iida5Sumio Yamada6Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, Nagoya, JapanDepartment of Cardiac Rehabilitation, Toyohashi Heart Center, Toyohashi, JapanDepartment of Hygiene & Public Health, Osaka Medical and Pharmaceutical University, Takatsuki, JapanDepartment of Rehabilitation, Hirakata Kohsai Hospital, Hirakata, JapanDepartment of Rehabilitation, Tazuke Kofukai Medical Institute Kitano Hospital, Osaka, JapanDepartment of Physical Therapy, Toyohashi SOZO University, Toyohashi, JapanDepartment of Integrated Health Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan; Corresponding author. PT Department of Cardiology, Aichi Medical University 1Yazakokarimata, Nagakute, 480TEL, Japan.Background: Research regarding cardiac rehabilitation (CR) in the prognosis of heart failure (HF) patients and frailty remains lacking. Here, the effects of CR on the 2-year prognosis of HF patients were examined according to their frailty status. Methods: This multicenter prospective cohort study enrolled patients hospitalized for HF. Patients who underwent ≥1 session per 2 weeks of CR within 3 months after discharge were categorized in the CR group. Patients were divided in a non-frailty (≤8 points) and physical frailty group (≥9 points) based on their FLAGSHIP frailty score. The score is based on HF prognosis, with a higher score indicating worsened physical frailty. A propensity score-matched analysis was performed to compare survival rates between the two groups according to their physical frailty status. Endpoints included HF re-hospitalization and all-cause mortality during a 2-year follow-up period. Results: Of 2697 patients included in the analysis, 285 and 95 matched pairs were distributed in the non-frailty and physical frailty groups, respectively, after propensity-score matching. CR was associated with lower incidence of HF rehospitalization in both non-frailty (hazard ratio 0.65; 95% confidence interval 0.44–0.96; p = 0.032) and physical frailty (0.54; 0.32–0.90; p = 0.019) groups. CR was not associated with all-cause mortality in either group (log-rank test, p > 0.05). Conclusion: These findings suggest the effects of CR on reduced HF rehospitalization, regardless of physical frailty status.http://www.sciencedirect.com/science/article/pii/S2772487523000107Cardiac rehabilitationHeart failurePhysical frailty |
| spellingShingle | Takuji Adachi Naoki Iritani Kuniyasu Kamiya Kotaro Iwatsu Kenta Kamisaka Yuki Iida Sumio Yamada Prognostic effects of cardiac rehabilitation in heart failure patients classified according to physical frailty: A propensity score–matched analysis of a nationwide prospective cohort study International Journal of Cardiology. Cardiovascular Risk and Prevention Cardiac rehabilitation Heart failure Physical frailty |
| title | Prognostic effects of cardiac rehabilitation in heart failure patients classified according to physical frailty: A propensity score–matched analysis of a nationwide prospective cohort study |
| title_full | Prognostic effects of cardiac rehabilitation in heart failure patients classified according to physical frailty: A propensity score–matched analysis of a nationwide prospective cohort study |
| title_fullStr | Prognostic effects of cardiac rehabilitation in heart failure patients classified according to physical frailty: A propensity score–matched analysis of a nationwide prospective cohort study |
| title_full_unstemmed | Prognostic effects of cardiac rehabilitation in heart failure patients classified according to physical frailty: A propensity score–matched analysis of a nationwide prospective cohort study |
| title_short | Prognostic effects of cardiac rehabilitation in heart failure patients classified according to physical frailty: A propensity score–matched analysis of a nationwide prospective cohort study |
| title_sort | prognostic effects of cardiac rehabilitation in heart failure patients classified according to physical frailty a propensity score matched analysis of a nationwide prospective cohort study |
| topic | Cardiac rehabilitation Heart failure Physical frailty |
| url | http://www.sciencedirect.com/science/article/pii/S2772487523000107 |
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