Cardiac Rehabilitation for Older Women with Heart Failure
Background: the role that sex plays in impacting cardiac rehabilitation (CR) outcomes remains an important gap in knowledge. Methods: we assessed sex differences in clinical and functional outcomes in 2345 older patients with heart failure (HF) admitted to inpatient CR. Three outcomes were considere...
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MDPI AG
2022-11-01
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| Series: | Journal of Personalized Medicine |
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| Online Access: | https://www.mdpi.com/2075-4426/12/12/1980 |
| _version_ | 1797456882468651008 |
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| author | Domenico Scrutinio Pietro Guida Laura Adelaide Dalla Vecchia Ugo Corrà Andrea Passantino |
| author_facet | Domenico Scrutinio Pietro Guida Laura Adelaide Dalla Vecchia Ugo Corrà Andrea Passantino |
| author_sort | Domenico Scrutinio |
| collection | DOAJ |
| description | Background: the role that sex plays in impacting cardiac rehabilitation (CR) outcomes remains an important gap in knowledge. Methods: we assessed sex differences in clinical and functional outcomes in 2345 older patients with heart failure (HF) admitted to inpatient CR. Three outcomes were considered: (1) the composite outcome of death during the index admission to CR or transfer to acute care; (2) three-year mortality; (3) change in six-minute walking distance (6MWD) from admission to discharge. Sex differences in outcomes were assessed using multivariable Cox or logistic regression models. Results: the hazard ratios of the composite outcome and of three-year mortality for females vs. males were 0.71 (95%CI:0.50–1.00; <i>p</i> = 0.049) and 0.68 (95%CI:0.59–0.79; <i>p</i> < 0.001), respectively. The standardized mean difference in 6MWD increase from admission to discharge between males and females was 0.10. The odds ratio of achieving an increase in 6MWD at discharge to values higher than the optimal sex-specific thresholds for predicting mortality for females vs. males was 2.21 (95%CI:1.53–3.20; <i>p</i> < 0.001). Conclusion: our findings suggest that older females with HF undergoing CR have better prognosis and garner similar improvement in 6MWD compared with their male counterparts. Nonetheless, females were more likely to achieve levels of functional capacity predictive of improved survival. |
| first_indexed | 2024-03-09T16:13:10Z |
| format | Article |
| id | doaj.art-b702ad7a8d1043f7b859cd92f22170a9 |
| institution | Directory Open Access Journal |
| issn | 2075-4426 |
| language | English |
| last_indexed | 2024-03-09T16:13:10Z |
| publishDate | 2022-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Personalized Medicine |
| spelling | doaj.art-b702ad7a8d1043f7b859cd92f22170a92023-11-24T16:01:33ZengMDPI AGJournal of Personalized Medicine2075-44262022-11-011212198010.3390/jpm12121980Cardiac Rehabilitation for Older Women with Heart FailureDomenico Scrutinio0Pietro Guida1Laura Adelaide Dalla Vecchia2Ugo Corrà3Andrea Passantino4Istituti Clinici Scientifici Maugeri SpA SB, IRCCS, Institute of Bari, 70100 Bari, ItalyIstituti Clinici Scientifici Maugeri SpA SB, IRCCS, Institute of Bari, 70100 Bari, ItalyIstituti Clinici Scientifici Maugeri SpA SB, IRCCS, Institute of Milan, 20138 Milan, ItalyIstituti Clinici Scientifici Maugeri SpA SB, IRCCS, Institute of Veruno, 28010 Veruno, ItalyIstituti Clinici Scientifici Maugeri SpA SB, IRCCS, Institute of Bari, 70100 Bari, ItalyBackground: the role that sex plays in impacting cardiac rehabilitation (CR) outcomes remains an important gap in knowledge. Methods: we assessed sex differences in clinical and functional outcomes in 2345 older patients with heart failure (HF) admitted to inpatient CR. Three outcomes were considered: (1) the composite outcome of death during the index admission to CR or transfer to acute care; (2) three-year mortality; (3) change in six-minute walking distance (6MWD) from admission to discharge. Sex differences in outcomes were assessed using multivariable Cox or logistic regression models. Results: the hazard ratios of the composite outcome and of three-year mortality for females vs. males were 0.71 (95%CI:0.50–1.00; <i>p</i> = 0.049) and 0.68 (95%CI:0.59–0.79; <i>p</i> < 0.001), respectively. The standardized mean difference in 6MWD increase from admission to discharge between males and females was 0.10. The odds ratio of achieving an increase in 6MWD at discharge to values higher than the optimal sex-specific thresholds for predicting mortality for females vs. males was 2.21 (95%CI:1.53–3.20; <i>p</i> < 0.001). Conclusion: our findings suggest that older females with HF undergoing CR have better prognosis and garner similar improvement in 6MWD compared with their male counterparts. Nonetheless, females were more likely to achieve levels of functional capacity predictive of improved survival.https://www.mdpi.com/2075-4426/12/12/1980heart failurecardiovascular rehabilitationpersonalized treatment |
| spellingShingle | Domenico Scrutinio Pietro Guida Laura Adelaide Dalla Vecchia Ugo Corrà Andrea Passantino Cardiac Rehabilitation for Older Women with Heart Failure Journal of Personalized Medicine heart failure cardiovascular rehabilitation personalized treatment |
| title | Cardiac Rehabilitation for Older Women with Heart Failure |
| title_full | Cardiac Rehabilitation for Older Women with Heart Failure |
| title_fullStr | Cardiac Rehabilitation for Older Women with Heart Failure |
| title_full_unstemmed | Cardiac Rehabilitation for Older Women with Heart Failure |
| title_short | Cardiac Rehabilitation for Older Women with Heart Failure |
| title_sort | cardiac rehabilitation for older women with heart failure |
| topic | heart failure cardiovascular rehabilitation personalized treatment |
| url | https://www.mdpi.com/2075-4426/12/12/1980 |
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