Article

There is an inverse relationship between phase 2 cardiac rehabilitation
(CR) visits and all-cause mortality. Phase 3 CR is a maintenance exercise program
for which clinical outcomes are uncertain. This retrospective study describes the
association between phase 3 CR participation and clinical events among patients
with ischemic heart disease after completion of phase 2 CR. METHODS: Patients who
completed 12 visits of phase 2 CR as provided by their health insurance were
categorized on the basis of their frequency of participation (ie, none,
irregular, and regular) in phase 3 CR during the 8 weeks after phase 2 CR. Cox
regression analysis was used to evaluate the association between phase 3 CR
participation and risk for a composite outcome that included all-cause mortality,
nonfatal myocardial infarction, or heart failure hospitalization. RESULTS: Among
2039 patients (32% women; age = 59 +/- 10 years) who completed phase 2 CR, 101
were regular and 129 were irregular participants of phase 3 CR. Over a median
followup of 5.6 years, 556 (27%) patients experienced the outcome. Neither
irregular nor regular participation in phase 3 CR was significantly associated
with risk for the outcome in unadjusted (P = .671 and P = .396, respectively) or
adjusted (P = .737 and P = .890, respectively) analyses. CONCLUSIONS: We did not
observe an incremental clinical benefit from weekly participation in Phase 3 CR
after completion of phase 2 CR among patients with ischemic heart disease.
Additional research addressing the dose-response relationship between phase 2 and
3 CR and clinical outcomes is needed.

Langue : ANGLAIS