Abstract 20428: Contemporary Therapy of Ischemic Heart Disease Predict Exercise Capacity After Cardiac Rehabilitation

Hypothesis: Method of revascularization for ischemic heart disease and current treatment of major risk factors have a differential impact on exercise capacity (EC) after cardiac rehabilitation program (CR). Methods: Retrospective cohort study of 541 consecutive patients that underwent CR at Mayo Clinic Florida from 2003-2014. We analyzed baseline demographics, referral diagnosis, medication use, lipid profile and hemodynamic measurements. The 6-minute walk test (6MWT) was the surrogate marker for the impact of CR. Multivariable linear regression analysis was used to develop a model to predict 6MWT after completion of CR. Results: Mean age of cohort was 74 years, 28 % female. Referral diagnosis was CABG surgery ( 29 %), MI (24 %), PCI (16 %), Stable angina (13 %) and valve surgery (10 %). Medication use was lipid-lowering (86 %), beta-blocker (77 %), ACE-inhibitor (51 %) anticoagulant (86 %). The variables with significant effect in the estimated difference in 6MWT meters (m) after CR (assuming other variables constant): Age (83 vs. 68 years) -32.7 m; Sex (female vs. male) -15.2 m; Referral diagnosis (vs. CABG) PCI -23.3 m; body mass index (31.3 vs. 25.3) -6.8 m; SBP at rest (130 vs. 104 mmHg) -8.8 m; baseline 6MWT distance (448.6 vs. 321.9 m) 96 m; LDL-C, lipid-lowering therapy and their interaction also had significant effect (Fig. 1). Conclusions: Surgical revascularization was associated with greater EC after CR than PCI. Lower LDL cholesterol on treatment with lipid-lowering therapy was associated with lower EC after CR. If these findings are corroborated in subsequent studies, special attention to individuals with potentially adverse characteristics can improve the benefit of CR.