Effectiveness of Intensive Cardiac Rehabilitation in High-Risk Patients with Cardiovascular Disease in Real-World Practice

Structured lifestyle interventions through cardiac rehabilitation (CR) are critical to improving the outcome of patients with cardiovascular disease (CVD) and cardiometabolic risk factors. CR programs’ variability in real-world practice may impact CR effects. This study evaluates intensive CR (ICR)...

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Autores principales:	Iwona Świątkiewicz, Salvatore Di Somma, Ludovica De Fazio, Valerio Mazzilli, Pam R. Taub
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	cardiovascular disease cardiovascular risk factors cardiometabolic risks obesity secondary prevention lifestyle intervention Nutrition. Foods and food supply TX341-641
Acceso en línea:	https://doaj.org/article/fb0d96698ec74b9c8b277c45e824aa74
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spelling	oai:doaj.org-article:fb0d96698ec74b9c8b277c45e824aa742021-11-25T18:34:59ZEffectiveness of Intensive Cardiac Rehabilitation in High-Risk Patients with Cardiovascular Disease in Real-World Practice10.3390/nu131138832072-6643https://doaj.org/article/fb0d96698ec74b9c8b277c45e824aa742021-10-01T00:00:00Zhttps://www.mdpi.com/2072-6643/13/11/3883https://doaj.org/toc/2072-6643Structured lifestyle interventions through cardiac rehabilitation (CR) are critical to improving the outcome of patients with cardiovascular disease (CVD) and cardiometabolic risk factors. CR programs’ variability in real-world practice may impact CR effects. This study evaluates intensive CR (ICR) and standard CR (SCR) programs for improving cardiometabolic, psychosocial, and clinical outcomes in high-risk CVD patients undergoing guideline-based therapies. Both programs provided lifestyle counseling and the same supervised exercise component. ICR additionally included a specialized plant-based diet, stress management, and social support. Changes in body weight (BW), low-density lipoprotein cholesterol (LDL-C), and exercise capacity (EC) were primary outcomes. A total of 314 patients (101 ICR and 213 SCR, aged 66 ± 13 years, 75% overweight/obese, 90% coronary artery disease, 29% heart failure, 54% non-optimal LDL-C, 43% depressive symptoms) were included. Adherence to ICR was 96% vs. 68% for SCR. Only ICR resulted in a decrease in BW (3.4%), LDL-C (11.3%), other atherogenic lipids, glycated hemoglobin, and systolic blood pressure. Both ICR and SCR increased EC (52.2% and 48.7%, respectively) and improved adiposity indices, diastolic blood pressure, cholesterol intake, depression, and quality of life, but more for ICR. Within 12.6 ± 4.8 months post-CR, major adverse cardiac events were less likely in the ICR than SCR group (11% vs. 17%), especially heart failure hospitalizations (2% vs. 8%). A comprehensive ICR enhanced by a plant-based diet and psychosocial management is feasible and effective for improving the outcomes in high-risk CVD patients in real-world practice.Iwona ŚwiątkiewiczSalvatore Di SommaLudovica De FazioValerio MazzilliPam R. TaubMDPI AGarticlecardiovascular diseasecardiovascular risk factorscardiometabolic risksobesitysecondary preventionlifestyle interventionNutrition. Foods and food supplyTX341-641ENNutrients, Vol 13, Iss 3883, p 3883 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	cardiovascular disease cardiovascular risk factors cardiometabolic risks obesity secondary prevention lifestyle intervention Nutrition. Foods and food supply TX341-641
spellingShingle	cardiovascular disease cardiovascular risk factors cardiometabolic risks obesity secondary prevention lifestyle intervention Nutrition. Foods and food supply TX341-641 Iwona Świątkiewicz Salvatore Di Somma Ludovica De Fazio Valerio Mazzilli Pam R. Taub Effectiveness of Intensive Cardiac Rehabilitation in High-Risk Patients with Cardiovascular Disease in Real-World Practice
description	Structured lifestyle interventions through cardiac rehabilitation (CR) are critical to improving the outcome of patients with cardiovascular disease (CVD) and cardiometabolic risk factors. CR programs’ variability in real-world practice may impact CR effects. This study evaluates intensive CR (ICR) and standard CR (SCR) programs for improving cardiometabolic, psychosocial, and clinical outcomes in high-risk CVD patients undergoing guideline-based therapies. Both programs provided lifestyle counseling and the same supervised exercise component. ICR additionally included a specialized plant-based diet, stress management, and social support. Changes in body weight (BW), low-density lipoprotein cholesterol (LDL-C), and exercise capacity (EC) were primary outcomes. A total of 314 patients (101 ICR and 213 SCR, aged 66 ± 13 years, 75% overweight/obese, 90% coronary artery disease, 29% heart failure, 54% non-optimal LDL-C, 43% depressive symptoms) were included. Adherence to ICR was 96% vs. 68% for SCR. Only ICR resulted in a decrease in BW (3.4%), LDL-C (11.3%), other atherogenic lipids, glycated hemoglobin, and systolic blood pressure. Both ICR and SCR increased EC (52.2% and 48.7%, respectively) and improved adiposity indices, diastolic blood pressure, cholesterol intake, depression, and quality of life, but more for ICR. Within 12.6 ± 4.8 months post-CR, major adverse cardiac events were less likely in the ICR than SCR group (11% vs. 17%), especially heart failure hospitalizations (2% vs. 8%). A comprehensive ICR enhanced by a plant-based diet and psychosocial management is feasible and effective for improving the outcomes in high-risk CVD patients in real-world practice.
format	article
author	Iwona Świątkiewicz Salvatore Di Somma Ludovica De Fazio Valerio Mazzilli Pam R. Taub
author_facet	Iwona Świątkiewicz Salvatore Di Somma Ludovica De Fazio Valerio Mazzilli Pam R. Taub
author_sort	Iwona Świątkiewicz
title	Effectiveness of Intensive Cardiac Rehabilitation in High-Risk Patients with Cardiovascular Disease in Real-World Practice
title_short	Effectiveness of Intensive Cardiac Rehabilitation in High-Risk Patients with Cardiovascular Disease in Real-World Practice
title_full	Effectiveness of Intensive Cardiac Rehabilitation in High-Risk Patients with Cardiovascular Disease in Real-World Practice
title_fullStr	Effectiveness of Intensive Cardiac Rehabilitation in High-Risk Patients with Cardiovascular Disease in Real-World Practice
title_full_unstemmed	Effectiveness of Intensive Cardiac Rehabilitation in High-Risk Patients with Cardiovascular Disease in Real-World Practice
title_sort	effectiveness of intensive cardiac rehabilitation in high-risk patients with cardiovascular disease in real-world practice
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/fb0d96698ec74b9c8b277c45e824aa74
work_keys_str_mv	AT iwonaswiatkiewicz effectivenessofintensivecardiacrehabilitationinhighriskpatientswithcardiovasculardiseaseinrealworldpractice AT salvatoredisomma effectivenessofintensivecardiacrehabilitationinhighriskpatientswithcardiovasculardiseaseinrealworldpractice AT ludovicadefazio effectivenessofintensivecardiacrehabilitationinhighriskpatientswithcardiovasculardiseaseinrealworldpractice AT valeriomazzilli effectivenessofintensivecardiacrehabilitationinhighriskpatientswithcardiovasculardiseaseinrealworldpractice AT pamrtaub effectivenessofintensivecardiacrehabilitationinhighriskpatientswithcardiovasculardiseaseinrealworldpractice
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Effectiveness of Intensive Cardiac Rehabilitation in High-Risk Patients with Cardiovascular Disease in Real-World Practice

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