New tool may help detect patients in need of individualized rehabilitation after cardiac event
Through a retrospective analysis, researchers have developed a prediction model tool to help identify patients that will show suboptimal improvement in exercise capacity with cardiac rehabilitation after a cardiac event and may benefit more from individualized programs to help increase their exercise capacities.
“Our primary aim was to develop a tool to identify those with suboptimal improvement in [exercise capacity] after [cardiac rehabilitation],” Johannes Bargehr, MD, MPhil, from the department of cardiovascular diseases at Mayo Clinic in Jacksonville, Florida, and the division of cardiovascular medicine at University of Cambridge, Addenbrooke’s Hospital, United Kingdom, and colleagues wrote in the abstract.
“We developed a multivariate linear regression model and corresponding nomogram to predict [exercise capacity] after [cardiac rehabilitation],” the researchers wrote.
A total of 541 patients (mean age, 74 years; 72% men) who were included in a phase 2 cardiac rehabilitation program were retrospectively analyzed. All patients had a previous cardiac event or intervention from 2003 to 2004. The 6-minute walk test was used to assess exercise capacity. The researchers developed a multivariate linear regression model and corresponding nomogram including the following predictors in the final model: age, sex, baseline exercise capacity, primary referral diagnosis, BMI, systolic BP at rest, triglycerides, LDL, lipid-lowering medication use and an interaction term of LDL with lipid-lowering therapy.
According to the researchers, the model can be used to predict exercise capacity after cardiac rehabilitation, and has been internally validated using bootstrap methods.
The final model had an adjusted R2 of 0.71 and after internal validation through 1,000 bootstrap resamples, the corrected R2 was 0.7, Bargehr and colleagues wrote.
“Taken collectively, patients with lower [exercise capacity] at baseline, advanced age, post-PCI, lower LDL on [lipid-lowering drugs] or baseline elevated LDL without [lipid-lowering drugs], female gender, higher BMI, and triglycerides were predictive for lesser improvement in functional status during [cardiac rehabilitation]. Hence, personalized treatment plans for such patients appear warranted in these groups to promote greater improvements in functional capacity and the related benefits,” Bargehr and colleagues wrote. – by Suzanne Reist
Disclosure: The researchers report no relevant financial disclosures.