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Sex Differences in Adherence and Functional Outcomes in Phase II Cardiac Rehabilitation: A Single-Center Cohort
Session:
Sessão de Posters 36 - Reabilitação para todos: equidade, inovação e impacto a longo prazo
Speaker:
Felipe Souza Leão
Congress:
CPC 2026
Topic:
J. Preventive Cardiology
Theme:
29. Rehabilitation and Sports Cardiology
Subtheme:
29.2 Cardiovascular Rehabilitation
Session Type:
Posters Eletrónicos
FP Number:
---
Authors:
Felipe Leão; Francisco Rocha Cardoso; Ana Raquel Santos; Daniela Pinheiro; Joana Silva; Joana Pinto; Miguel Trindade; Vânia Martins; Carlos Franco; Rui Costa; Rui Cruz Ferreira; Pedro Rio
Abstract
<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif">Sex disparities in referral, participation and outcomes of cardiac rehabilitation (CR) are well described, with women historically under-represented and often perceived to derive smaller functional benefits. Whether these differences persist in modern, structured CR programs remains uncertain.</span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><strong>Methods:</strong><br /> We analyzed 330 consecutive patients enrolled in a Phase II CR program between 2020 and 2025. Patients were referred to standard Phase II CR based on established clinical indications. Adherence was assessed as the percentage of completed sessions, with high adherence defined as ≥80% of prescribed sessions. Functional capacity was evaluated using the 6-minute walk test (6MWT) and cardiopulmonary exercise testing (VO2 peak) before and after CR. Sex-specific comparisons were performed using t-tests or Mann–Whitney U tests, with significance set at p<0.05. Functional follow-up was available in the majority of patients.</span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><strong>Results:</strong><br /> Of 330 patients, 75% were male (n=248). Median age did not differ between sexes (Female: 60 vs Male: 57 years; p=0.18). High adherence was observed in 85.5% of females and 90.5% of males (p=0.43). Mean adherence percentage was similarly high in both groups (Female: 92.1±16.1% vs Male: 93.9±14.1%; p=0.46). Complete functional assessment was available in 214 patients. Men showed higher absolute 6MWT distances at baseline (480±85 vs 561±90 m; p<0.001) and after CR (522±83 vs 611±103 m; p<0.001), yet Δ6MWT did not differ significantly (Female: +42±47.8 m vs Male: +50±61.6 m; p=0.34). Similarly, men demonstrated higher absolute VO2 values at baseline and post-CR (both p<0.001), but gains were comparable (ΔVO2: Female +2.58±3.44 vs Male +2.99±3.54 mL/kg/min; p=0.62). Functional follow-up completion did not differ by sex.</span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><strong>Conclusion:</strong><br /> Despite lower representation, women demonstrated high adherence and achieved functional improvements comparable to men. Although men exhibited higher absolute performance, sex did not influence the magnitude of improvement. These findings align with contemporary literature showing that, once enrolled and adherent, women benefit from CR to the same extent as men, highlighting the importance of equitable referral pathways.</span></span></p>
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