SPC365

Adherence to Phase 3 Cardiac Rehabilitation: Predictors and Outcomes

Session: SESSÃO DE POSTERS 03 - REABILITAÇÃO CARDÍACA AO LONGO DO CONTINUUM DE CUIDADOS - DA PREVENÇÃO AOS RESULTADOS A LONGO PRAZO
Speaker: Catarina Sena Silva

Congress: CPC 2025
Topic: J. Preventive Cardiology
Theme: 29. Rehabilitation and Sports Cardiology
Subtheme: 29.2 Cardiovascular Rehabilitation
Session Type: Cartazes
FP Number: ---
Authors: Catarina Sena Silva; Ana Abrantes; Marta Vilela; Madalena Lemos Pires; Mariana Borges; Gonçalo Sá; Pedro Alves da Silva; Nelson Cunha; Inês Aguiar-Ricardo; Fausto J. Pinto; Ana Abreu; Rita Pinto

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="color:black">Introduction:&nbsp;</span></strong></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">Cardiac rehabilitation (CR) plays a vital role in enhancing recovery and long-term outcomes for patients following cardiovascular events. Adherence to CR programs often varies, which may influence </span>their effectiveness, making it crucial to identify factors that predict adherence and improve outcomes.</span></span></p>

<p style="text-align:justify">&nbsp;</p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="color:black">Purpose:&nbsp;&nbsp;</span></strong></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">To evaluate predictors of adherence to phase 3 CR and the impact of adherence on clinical outcomes.</span></span></span></p>

<p>&nbsp;</p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="color:black">Methods: </span></strong>&nbsp;</span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">Retrospective observational single-center study including patients enrolled in a phase 3 CR program between 2016 and 2024. We analyzed social characteristics, cardiovascular risk factors, clinical indications for referral and data from lab tests, transthoracic echocardiography and cardiopulmonary exercise testing. Adherence to the program was established based on whether patients were still in the program at the time of data collection (2024). Clinical outcomes were measured using a composite of all-cause mortality, cardiovascular hospitalizations and urgent care visits</span></span></span></p>

<p>&nbsp;</p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="color:black">Results:&nbsp; </span></strong><br />
<span style="color:black">A total of 284 patients (78% male, 61,2 &plusmn; 11,1 years) completed a phase 3 CR program. Common comorbidities included hypertension (50%), dyslipidemia (46%), diabetes (18%), active smoking (9%), atrial fibrillation (7%) and prior stroke (5%). Most of referrals were due to ischemic cardiomyopathy (84%). Regarding social and demographic factors, 60% of patients had attended college, with 32% holding at least a master&#39;s degree. A substantial&nbsp;portion of the cohort were employed (47%), while 39% were retired and 4% were unemployed. Most patients lived close to the phase 3 CR facility, with 62% reporting a travel time of less than 30 minutes. Additionally, 69% of patients were married.</span></span></span></p>

<p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">At the time of data collection, 68% of patients remained active in the phase 3 CR program, while 32% had dropped out. The primary reasons for dropout were incompatibility with work schedules (8%), significant changes in health status (7%) and the COVID-19 pandemic (7%). No statistically significant correlation was found between social and demographic factors (such as education level, profession, or distance from home to the rehabilitation facility) and dropout rates, except for marital status. Adherence was significantly higher in patients who were married compared to those who were single or widowed (p=0.028).&nbsp;</span></span></span></p>

<p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">During a mean follow-up of 3.4 &plusmn; 2.4 years, there were 4 deaths, 13 cardiovascular-related hospitalizations and 34 urgent cardiovascular visits. A statistically significant association was found between dropout and adverse events (p=0.028), with a trend toward better outcomes for patients who remained active in the program (p=0.2).&nbsp;</span></span></span></p>

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<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="color:black">Conclusions:&nbsp;</span></strong></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">Our findings reveal no clear association between sociodemographic factors and adherence to phase 3 CR. However, there was an association between adherence and improved clinical outcomes. Therefore, it is essential to promote adherence for all patients.</span></span></span></p>