SPC365

Age-related differences in cardiovascular rehabilitation programs – 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; Mariana Carvalho; Margarida Cabral; 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) consists of a patient-centered multidisciplinary program with multiple benefits in secondary prevention. Misconceptions about older patients may lead to lower referral rates.</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 age-related differences in CR (&le;50 vs.&gt;50 years).</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 our CR program (2017-2024). Baseline characteristics, major adverse cardiovascular events (MACE) &ndash; a composite of death, non-fatal acute myocardial infarction (MI), cardiovascular rehospitalization and stroke-, quality of life (EuroQoL five-dimensional score), Hospital Anxiety and Depression Scale (HADS), exercise testing (ET) in METs (metabolic equivalents), International Physical Activity Questionnaire short-form (IPAQsf) (total physical activity METs-minutes/week), body mass index (BMI), abdominal circumference, lipid profile and hemoglobin A1c were compared.</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 307 patients, 69% were male and 20% were &le;50 years old. Admission diagnoses consisted of ST-elevation MI (STEMI) (55%), non-ST-elevation MI (NSTEMI) (37%), heart failure (6%) and unstable angina (2%). 94% underwent percutaneous coronary intervention at the index event, while 5% underwent coronary artery bypass grafting. Dyslipidemia (78%), hypertension (59%), and active smoking (45%) were the most common risk factors. Both one-year MACE and follow-up MACE were low, occurring only in the older group (3.3%, 7.8%).</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">Younger patients were more commonly diagnosed with STEMI (p=0.002), while older patients had significantly more NSTEMI (p=0.0018). Younger patients had lower rates of hypertension (&lt;0.001), diabetes (0.001) and previous coronary heart disease (p=0.006). Conversely, they were more frequently smokers (p&lt;0.001).</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">EuroQoL, HADS depression and IPAQsf scores were similar between groups, except for HADS anxiety, which was higher in younger patients. Although functional capacity in ET was significantly better in younger patients at baseline and at the end of CR (p&lt;0.001), PE improvements were similar between groups (p=0.399). Low-density lipoprotein cholesterol (LDL-c) was significantly higher at baseline in younger patients (p=0.048) and triglycerides (TG) lower at the end (p=0.046). LDL-c improvements were similar, though TG improvement was greater in the younger group (p=0.001). </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">Despite differences in baseline characteristics, CR is seems equally beneficial in young and older patients. Nevertheless, tailored programs are of the utmost importance for the success of CR, particularly in frailer patients.</span></span></span></p>