Cardiac rehabilitation benefits heart failure patients—but for how long?
Cardiac rehabilitation (CR) is a routine treatment for patients with heart failure (HF), but what is its long-term impact on patient outcomes? A group of researchers asked that very question, sharing its findings in the American Journal of Cardiology.
The group analyzed 2,876 patients who were hospitalized with acute HF or deteriorating chronic HF. Of the 2,876 patients, 313 underwent CR for six months. Fifty-nine-percent of the patients were men, and the median patient age was 74 years old. All data came from the FLAGSHIP study.
Overall, the study determined that regular participation in CR for six months after discharge was linked with a decreased risk of clinical events. CR's effect was similar in patients with HF with preserved ejection fraction greater than 50% and HF with reduced ejection fraction less than 40%.
However, CR did not reduce the rates of all-cause mortality or HF rehospitalization beyond those initial six months after discharge; the researchers had originally been evaluating if CR's impact might last for two full years.
“Considering that the length of the outpatient CR program is usually five to six months in Japan, this result suggests that the effects of CR are attenuated after completion of the CR program,” wrote lead author Takuji Adachi, PhD, PT, with the department of integrated health sciences at Nagoya University Graduate School of Medicine in Japan, and colleagues.
Takuji et al. noted that there are several explanations for the outcome.
For starters, they said, the results of the post six-month examination may have been affected by survival bias. Also, the lack of CR effects after six months signifies the insufficient effects of CR on risk factors associated with long-term prognosis.
According to the authors, the study did have limitations.
For example, selection bias could not be excluded, because the CR participation rate in this was higher than that in another nationwide group in Japan. In addition, data regarding CR content and participation beyond six months after discharge were not collected.
Also, changes in medications and implanted devices during follow-up were not evaluated, and CR frequency was categorized based on medical records.
Read the full study here.