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. 2023 Nov;116(5):1099-1105.
doi: 10.1016/j.athoracsur.2023.05.044. Epub 2023 Jun 29.

Cardiac Rehabilitation Reduces 2-Year Mortality After Coronary Artery Bypass Grafting

Tyler M Bauer  1 , Jessica M Yaser  2 , Temilolaoluwa Daramola  1 , Alexandra I Mansour  1 , Gorav Ailawadi  1 , Francis D Pagani  3 , Patricia Theurer  4 , Donald S Likosky  3 , Steven J Keteyian  5 , Michael P Thompson  6
Affiliations

Cardiac Rehabilitation Reduces 2-Year Mortality After Coronary Artery Bypass Grafting

Tyler M Bauer et al. Ann Thorac Surg. 2023 Nov.

Abstract

Background: Cardiac rehabilitation (CR) is a supervised outpatient exercise and risk reduction program offered to patients who have undergone coronary revascularization procedures. Multiple professional societal guidelines support the use of CR after coronary artery bypass grafting (CABG) based on studies in combined percutaneous coronary intervention and CABG populations with surrogate outcomes. This statewide analysis of patients undergoing CABG evaluated the relationship between CR use and long-term mortality.

Methods: Medicare fee-for-service claims were linked to surgical data for patients discharged alive after isolated CABG from January 1, 2015, through September 30, 2019. Outpatient facility claims were used to identify any CR use within 1 year of discharge. Death within 2 years of discharge was the primary outcome. Mixed-effects logistic regression was used to predict CR use, adjusting for a variety of comorbidities. Unadjusted and inverse probability treatment weighting (IPTW) were used to compare 2-year mortality among CR users vs nonusers.

Results: A total of 3848 of 6412 patients (60.0%) were enrolled in CR for an average of 23.2 (SD, 12.0) sessions, with 770 of 6412 (12.0%) completing all recommended 36 sessions. Logistic regression identified increasing age, discharge to home (vs extended care facility), and shorter length of stay as predictors of postdischarge CR use (P < .05). Unadjusted and IPTW analyses showed significant reduction in 2-year mortality in CR users compared with CR nonusers (unadjusted: 9.4% reduction; 95% CI, 10.8%-7.9%; P < .001; IPTW: -4.8% reduction; 95% CI, 6.0%-3.5%; P < .001).

Conclusions: These data suggest that CR use is associated with lower 2-year mortality. Future quality initiatives should consider identifying and addressing root causes of poor CR enrollment and completion.

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Conflict of interest statement

Conflicts of Interest

Dr. Thompson receives funding from Blue Cross Blue Shield of Michigan for his role as Co-Director of the Michigan Value Collaborative.

Figures

Figure 1:
Figure 1:
Distribution of Cardiac Rehabilitation sessions attended amongst CABG patients post-discharge.
Figure 2:
Figure 2:
Hospital-level rates of Cardiac Rehabilitation referral and use (n=33 hospitals).
Figure 3:
Figure 3:
Crude two-year mortality rates by cardiac rehabilitation use status and categories of cardiac rehabilitation sessions.
See this image and copyright information in PMC

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References

    1. Mampuya WM. Cardiac rehabilitation past, present and future: an overview. Cardiovasc Diagn Ther. 2012;2(1):38–49. - PMC - PubMed
    1. Servey JT, Stephens M. Cardiac Rehabilitation: Improving Function and Reducing Risk. Am Fam Physician. 2016;94(1):37–43. - PubMed
    1. Anderson L, Thompson DR, Oldridge N, et al. Exercise-based cardiac rehabilitation for coronary heart disease. Cochrane Database Syst Rev. 2016;2016(1):CD001800. - PMC - PubMed
    1. O’Connor GT, Buring JE, Yusuf S, et al. An overview of randomized trials of rehabilitation with exercise after myocardial infarction. Circulation. 1989;80(2):234–244. - PubMed
    1. Oldridge NB, Guyatt GH, Fischer ME, Rimm AA. Cardiac rehabilitation after myocardial infarction. Combined experience of randomized clinical trials. JAMA. 1988;260(7):945–950. - PubMed