Article

Cardiac rehabilitation programs (CRPs) remain underutilized partly
because of access barriers.
We therefore evaluated a CRP with fewer center-based
sessions (rCRP) compared with standard CRP (sCRP) with respect to changes in
exercise capacity and cardiac risk factors.
METHODS: In this randomized
controlled noninferiority trial, primary and secondary prevention patients at low
and moderate risk were randomized to an sCRP (n = 60) or an rCRP (n = 61). Over 4
months, sCRP and rCRP participants attended 32 and 10 on-site cardiac
rehabilitation sessions, respectively. The primary outcome was the difference in
the change in exercise capacity from baseline at 4 and 16 months between the
groups measured in seconds from a maximal treadmill exercise test. Noninferiority
of the rCRP was tested with mixed-effects model analysis with a cut point of 60
seconds for the upper value of the group estimate. RESULTS: Attendance was higher
for the rCRP group (97% +/- 63% vs 71% +/- 22%, P = .002). Over 16 months,
exercise test time increased for the sCRP (524 +/- 168 to 604 +/- 172 seconds, P
< .01) and the rCRP (565 +/- 183 to 640 +/- 192 seconds, P < .01). The rCRP was
not inferior to the sCRP regarding changes in treadmill time (48.47 seconds, P =
.454). The rCRP was not inferior to the sCRP regarding metabolic and anthropometric risk factors. CONCLUSION: Our findings suggest that, for a
selected group of low-/moderate-risk patients, the number of center-based CRP
exercise sessions can be decreased while maintaining reduced cardiovascular risk
factors.

Langue : ANGLAIS