Article

Secondary prevention risk factor goals have been established by the
American Heart Association/American College of Cardiology, and the American Heart
Association has further delineated ideal cardiovascular health metrics. We
evaluated risk factor goal achievement during early-outpatient cardiac
rehabilitation (CR) and temporal trends in risk factor control. METHODS: Patients
completed assessments on entry into and exit from CR at 35 centers between 2000
and 2009 and were categorized into 3 cohorts: entire (N = 12 984), 2000-2004 (n =
5468), and 2005-2009 (n = 7516) cohorts. RESULTS: Improvements occurred in
multiple risk factors during CR. For the entire cohort, the percentages of
patients at goal at CR completion ranged from 95.5% for smoking to 21.9% for body
mass index (BMI) of <25.0 kg/m. Compared with 2000-2004, the percentage of the
2005-2009 cohort at goal was higher (P < .001) for blood pressure, low-density
lipoprotein cholesterol, and physical activity, lower (P = .005) for BMI, and not
significantly different (P > .05) for fasting glucose and smoking. At CR
completion, of those in the entire, 2000-2004, and 2005-2009 cohorts, 4.4%, 3.9%,
and 4.8% (P = .219 vs 2000-2004), respectively, had all biomarkers at the goal
for ideal cardiovascular health and, of those with atherosclerotic cardiovascular
disease, 70.8%, 71.5%, and 70.3% (P = .165 vs 2000-2004), respectively, were
receiving statins. CONCLUSIONS: The percentage of patients at goal at CR
completion increased for some, but not all, risk factors during 2005-2009 versus
2000-2004. Despite the benefits of CR, risk factor profiles are often suboptimal
after CR. There remains room for improvement in risk factor management during CR
and a need for continued intervention thereafter.

Langue : ANGLAIS