SPC365

Clinical challenges in cardiovascular rehabilitation programs: predictors of dropout – a single-centre analysis

Session: SESSÃO DE POSTERS 02 - RESULTADOS E AVALIAÇÃO DE PROGRAMAS DE REABILITAÇÃO CARDÍACA - DA PRÁTICA CLÍNICA AOS BENEFÍCIOS PARA O DOENTE
Speaker: Carolina Miguel Gonçalves

Congress: CPC 2025
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Session Type: Cartazes
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Authors: Carolina Gonçalves; Margarida Cabral; Mariana Carvalho; Adriana Vazão; André Martins; Joana Pereira; Mónica Amado; Fátima Saraiva; Filipa Januário; Alexandre Antunes

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><strong><span style="font-family:&quot;Calibri&quot;,sans-serif">Background</span></strong></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><span style="font-family:&quot;Calibri&quot;,sans-serif">Cardiovascular rehabilitation (CR) has demonstrated multiple benefits in patient prognosis. However, poor adherence to these programs remains a clinical challenge.</span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><strong><span style="font-family:&quot;Calibri&quot;,sans-serif">Purpose</span></strong></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><span style="font-family:&quot;Calibri&quot;,sans-serif">To describe the differences between dropout patients (Group 1) and the remaining patients (Group 2) regarding baseline characteristics and findings, and to identify predictors of dropout.</span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><strong><span style="font-family:&quot;Calibri&quot;,sans-serif">Methods</span></strong></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><span style="font-family:&quot;Calibri&quot;,sans-serif">Retrospective single-centre analysis of patients referred to the CR program between 2017 and 2024. Baseline characteristics, clinical findings, one-year and extended follow-up (FU) major adverse cardiovascular events (MACE) &ndash; a composite of death, non-fatal acute myocardial infarction (MI), cardiovascular rehospitalization and stroke &ndash; were compared. Quality of life (EuroQoL five-dimensional index), Hospital Anxiety and Depression Scale (HADS), International Physical Activity Questionnaire short form (IPAQsf) (total physical activity METs-minutes/week), exercise testing (ET) in METs (metabolic equivalents), body mass index (BMI), abdominal circumference, lipid profile and hemoglobin A1c at baseline were also compared. Multivariate logistic regression was performed to assess predictors of dropout.</span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><strong><span style="font-family:&quot;Calibri&quot;,sans-serif">Results</span></strong></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><span style="font-family:&quot;Calibri&quot;,sans-serif">From a total of 259 patients, 67% were male, with a mean age of 58 &plusmn; 9.4 years. Admission diagnoses were mainly ST-elevation MI (57%), non-ST-elevation MI (NSTEMI) (37%), and heart failure (4%). Approximately 95% underwent percutaneous coronary intervention at the index event. The past medical history was remarkable for dyslipidemia (78%), hypertension (61%) and active smoking (45%). Around 25% failed to complete CR program (Group 1).</span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><span style="font-family:&quot;Calibri&quot;,sans-serif">Age, past medical history, EuroQoL, IPAQsf and HADS scores, as well as blood analyses, were similar between the groups.</span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><span style="font-family:&quot;Calibri&quot;,sans-serif">Group 1 had more female patients (p&lt;0.001), fewer NSTEMI cases (p=0.035) and higher number of heart failure cases (p=0.007). Furthermore, at baseline, functional capacity in ET measured in METs was significantly lower and BMI was significantly higher in group 1. Both one-year MACE and FU MACE were low, and were statistically higher in the dropout group. After multivariate logistic regression, only female sex remained an independent predictor of CR dropout (<span style="color:black">OR = 8.662, 95% CI: 4.608-16.284, p-value&lt;0.001).</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><strong><span style="font-family:&quot;Calibri&quot;,sans-serif">Conclusions</span></strong></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><span style="font-family:&quot;Calibri&quot;,sans-serif">In our population, a high proportion of patients completed the CR program. Only female sex was an independent dropout predictor. Identifying risk factors for CR dropout may help in designing tailored interventions for these patients to improve adherence and, consequently, outcomes.</span></span></span></p>