Effectiveness of Intensive Cardiac Rehabilitation in High-Risk Patients with Cardiovascular Disease in Real-World Practice
Structured lifestyle interventions through cardiac rehabilitation (CR) are critical to improving the outcome of patients with cardiovascular disease (CVD) and cardiometabolic risk factors. CR programs’ variability in real-world practice may impact CR effects. This study evaluates intensive CR (ICR)...
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| Format: | Article |
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MDPI AG
2021-10-01
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| Series: | Nutrients |
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| Online Access: | https://www.mdpi.com/2072-6643/13/11/3883 |
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| author | Iwona Świątkiewicz Salvatore Di Somma Ludovica De Fazio Valerio Mazzilli Pam R. Taub |
| author_facet | Iwona Świątkiewicz Salvatore Di Somma Ludovica De Fazio Valerio Mazzilli Pam R. Taub |
| author_sort | Iwona Świątkiewicz |
| collection | DOAJ |
| description | Structured lifestyle interventions through cardiac rehabilitation (CR) are critical to improving the outcome of patients with cardiovascular disease (CVD) and cardiometabolic risk factors. CR programs’ variability in real-world practice may impact CR effects. This study evaluates intensive CR (ICR) and standard CR (SCR) programs for improving cardiometabolic, psychosocial, and clinical outcomes in high-risk CVD patients undergoing guideline-based therapies. Both programs provided lifestyle counseling and the same supervised exercise component. ICR additionally included a specialized plant-based diet, stress management, and social support. Changes in body weight (BW), low-density lipoprotein cholesterol (LDL-C), and exercise capacity (EC) were primary outcomes. A total of 314 patients (101 ICR and 213 SCR, aged 66 ± 13 years, 75% overweight/obese, 90% coronary artery disease, 29% heart failure, 54% non-optimal LDL-C, 43% depressive symptoms) were included. Adherence to ICR was 96% vs. 68% for SCR. Only ICR resulted in a decrease in BW (3.4%), LDL-C (11.3%), other atherogenic lipids, glycated hemoglobin, and systolic blood pressure. Both ICR and SCR increased EC (52.2% and 48.7%, respectively) and improved adiposity indices, diastolic blood pressure, cholesterol intake, depression, and quality of life, but more for ICR. Within 12.6 ± 4.8 months post-CR, major adverse cardiac events were less likely in the ICR than SCR group (11% vs. 17%), especially heart failure hospitalizations (2% vs. 8%). A comprehensive ICR enhanced by a plant-based diet and psychosocial management is feasible and effective for improving the outcomes in high-risk CVD patients in real-world practice. |
| first_indexed | 2024-03-10T05:12:25Z |
| format | Article |
| id | doaj.art-fb0d96698ec74b9c8b277c45e824aa74 |
| institution | Directory Open Access Journal |
| issn | 2072-6643 |
| language | English |
| last_indexed | 2024-03-10T05:12:25Z |
| publishDate | 2021-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Nutrients |
| spelling | doaj.art-fb0d96698ec74b9c8b277c45e824aa742023-11-23T00:47:27ZengMDPI AGNutrients2072-66432021-10-011311388310.3390/nu13113883Effectiveness of Intensive Cardiac Rehabilitation in High-Risk Patients with Cardiovascular Disease in Real-World PracticeIwona Świątkiewicz0Salvatore Di Somma1Ludovica De Fazio2Valerio Mazzilli3Pam R. Taub4Division of Cardiovascular Medicine, University of California San Diego, La Jolla, CA 92037, USADepartment of Medical-Surgery Sciences and Translational Medicine, Sapienza University of Rome, 00189 Rome, ItalyDepartment of Medical-Surgery Sciences and Translational Medicine, Sapienza University of Rome, 00189 Rome, ItalyDepartment of Medical-Surgery Sciences and Translational Medicine, Sapienza University of Rome, 00189 Rome, ItalyDivision of Cardiovascular Medicine, University of California San Diego, La Jolla, CA 92037, USAStructured lifestyle interventions through cardiac rehabilitation (CR) are critical to improving the outcome of patients with cardiovascular disease (CVD) and cardiometabolic risk factors. CR programs’ variability in real-world practice may impact CR effects. This study evaluates intensive CR (ICR) and standard CR (SCR) programs for improving cardiometabolic, psychosocial, and clinical outcomes in high-risk CVD patients undergoing guideline-based therapies. Both programs provided lifestyle counseling and the same supervised exercise component. ICR additionally included a specialized plant-based diet, stress management, and social support. Changes in body weight (BW), low-density lipoprotein cholesterol (LDL-C), and exercise capacity (EC) were primary outcomes. A total of 314 patients (101 ICR and 213 SCR, aged 66 ± 13 years, 75% overweight/obese, 90% coronary artery disease, 29% heart failure, 54% non-optimal LDL-C, 43% depressive symptoms) were included. Adherence to ICR was 96% vs. 68% for SCR. Only ICR resulted in a decrease in BW (3.4%), LDL-C (11.3%), other atherogenic lipids, glycated hemoglobin, and systolic blood pressure. Both ICR and SCR increased EC (52.2% and 48.7%, respectively) and improved adiposity indices, diastolic blood pressure, cholesterol intake, depression, and quality of life, but more for ICR. Within 12.6 ± 4.8 months post-CR, major adverse cardiac events were less likely in the ICR than SCR group (11% vs. 17%), especially heart failure hospitalizations (2% vs. 8%). A comprehensive ICR enhanced by a plant-based diet and psychosocial management is feasible and effective for improving the outcomes in high-risk CVD patients in real-world practice.https://www.mdpi.com/2072-6643/13/11/3883cardiovascular diseasecardiovascular risk factorscardiometabolic risksobesitysecondary preventionlifestyle intervention |
| spellingShingle | Iwona Świątkiewicz Salvatore Di Somma Ludovica De Fazio Valerio Mazzilli Pam R. Taub Effectiveness of Intensive Cardiac Rehabilitation in High-Risk Patients with Cardiovascular Disease in Real-World Practice Nutrients cardiovascular disease cardiovascular risk factors cardiometabolic risks obesity secondary prevention lifestyle intervention |
| title | Effectiveness of Intensive Cardiac Rehabilitation in High-Risk Patients with Cardiovascular Disease in Real-World Practice |
| title_full | Effectiveness of Intensive Cardiac Rehabilitation in High-Risk Patients with Cardiovascular Disease in Real-World Practice |
| title_fullStr | Effectiveness of Intensive Cardiac Rehabilitation in High-Risk Patients with Cardiovascular Disease in Real-World Practice |
| title_full_unstemmed | Effectiveness of Intensive Cardiac Rehabilitation in High-Risk Patients with Cardiovascular Disease in Real-World Practice |
| title_short | Effectiveness of Intensive Cardiac Rehabilitation in High-Risk Patients with Cardiovascular Disease in Real-World Practice |
| title_sort | effectiveness of intensive cardiac rehabilitation in high risk patients with cardiovascular disease in real world practice |
| topic | cardiovascular disease cardiovascular risk factors cardiometabolic risks obesity secondary prevention lifestyle intervention |
| url | https://www.mdpi.com/2072-6643/13/11/3883 |
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