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Erschienen in: Wiener klinische Wochenschrift 5-6/2014

01.03.2014 | original article

Long-term effects of outpatient cardiac rehabilitation in Austria: a nationwide registry

verfasst von: Prof. Josef Niebauer, MD, PhD, MBA, Karl Mayr, MD, Hanns Harpf, MD, Peter Hofmann, PhD, Edith Müller, PhD, Manfred Wonisch, MD, Rochus Pokan, MD, Werner Benzer, MD

Erschienen in: Wiener klinische Wochenschrift | Ausgabe 5-6/2014

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Summary

Aim

Our Working Group on Out-Patient Cardiac Rehabilitation (AGAKAR) has previously published guidelines, which were endorsed by the Austrian Society of Cardiology. It was the aim of this study to assess the short-term (phase II) and long-term (phase III) effects of these guidelines by use of a nationwide registry.

Methods

All Austrian out-patient rehabilitation facilities entered data into a database of all consecutive patients who completed phase II (4–6 weeks) and/or III (6–12 months) rehabilitation between 1.1.2009–30.11.2011.

Results

Data of 1432 phase II and 1390 phase III patients were assessed. Despite the wide spectrum of cardiac diseases patients’ exercise capacity improved during phase II by 20 (− 193 to 240) watts; 91.0 % reached a systolic blood pressure < 140 mmHg; 68.1 % an LDL < 100 mg/dl; 69.8 % triglycerides < 150 mg/dl, and 66.2 % of male patients had a waist circumference < 102 cm. During phase III improvement in cardiovascular risk factors, quality of life, anxiety, and depression were further improved in an increasing number of patients.

Conclusions

Our data demonstrate beneficial short- and long-term effects of the Austrian model of out-patient cardiac rehabilitation and provide support for comprehensive long-term rehabilitation programs. Furthermore, our model might be helpful for those who are at the verge of initiating or modifying their programs. It is also hoped that these data will motivate colleagues to refer their patients to out-patient cardiac rehabilitation facilities and that our results may stimulate insurance companies to grant further and comprehensive contracts to provide access for all suitable patients.
Literatur
1.
Zurück zum Zitat Jolliffe JA, Rees K, Taylor RS, Thompson D, Oldridge N, Ebrahim S. Exercise-based rehabilitation for coronary heart disease. Cochrane Database Syst Rev. 2001;(1):CD001800. Jolliffe JA, Rees K, Taylor RS, Thompson D, Oldridge N, Ebrahim S. Exercise-based rehabilitation for coronary heart disease. Cochrane Database Syst Rev. 2001;(1):CD001800.
2.
Zurück zum Zitat 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):234–44.PubMedCrossRef 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):234–44.PubMedCrossRef
3.
Zurück zum Zitat Oldridge NB, Guyatt GH, Fischer ME, Rimm AA. Cardiac rehabilitation after myocardial infarction. Combined experience of randomized clinical trials. JAMA. 1988;260:945–50.PubMedCrossRef Oldridge NB, Guyatt GH, Fischer ME, Rimm AA. Cardiac rehabilitation after myocardial infarction. Combined experience of randomized clinical trials. JAMA. 1988;260:945–50.PubMedCrossRef
4.
Zurück zum Zitat Taylor RS, Brown A, Ebrahim S, et al. Exercise-based rehabilitation for patients with coronary heart disease: systematic review and meta-analysis of randomized controlled trials. Am J Med. 2004;116(10):682–92.PubMedCrossRef Taylor RS, Brown A, Ebrahim S, et al. Exercise-based rehabilitation for patients with coronary heart disease: systematic review and meta-analysis of randomized controlled trials. Am J Med. 2004;116(10):682–92.PubMedCrossRef
5.
Zurück zum Zitat Hammill BG, Curtis LH, Schulman KA, Whellan DJ. Relationship between cardiac rehabilitation and long-term risks of death and myocardial infarction among elderly medicare beneficiaries. Circulation. 2010;121:63–70.PubMedCentralPubMedCrossRef Hammill BG, Curtis LH, Schulman KA, Whellan DJ. Relationship between cardiac rehabilitation and long-term risks of death and myocardial infarction among elderly medicare beneficiaries. Circulation. 2010;121:63–70.PubMedCentralPubMedCrossRef
6.
Zurück zum Zitat Niebauer J, Mayr K, Tschentscher M, Pokan R, Benzer W. Outpatient cardiac rehabilitation: The Austrian model. Eur J Prev Cardiol. 2012 Apr 16; Epub ahead of print. Niebauer J, Mayr K, Tschentscher M, Pokan R, Benzer W. Outpatient cardiac rehabilitation: The Austrian model. Eur J Prev Cardiol. 2012 Apr 16; Epub ahead of print.
7.
Zurück zum Zitat Perk J, De Backer G, Gohlke H, Graham I, Reiner Z, Verschuren M, Albus C, Benlian P, Boysen G, Cifkova R, Deaton C, Ebrahim S, Fisher M, Germano G, Hobbs R, Hoes A, Karadeniz S, Mezzani A, Prescott E, Ryden L, Scherer M, Syvänne M, Scholte op RWJ, Vrints C, Wood D, Zamorano JL. Zannad F; European Association for Cardiovascular Prevention & Rehabilitation (EACPR); ESC Committee for Practice Guidelines (CPG). European Guidelines on cardiovascular disease prevention in clinical practice (version 2012). The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts). Eur Heart J. 2012;33:1635–701.PubMedCrossRef Perk J, De Backer G, Gohlke H, Graham I, Reiner Z, Verschuren M, Albus C, Benlian P, Boysen G, Cifkova R, Deaton C, Ebrahim S, Fisher M, Germano G, Hobbs R, Hoes A, Karadeniz S, Mezzani A, Prescott E, Ryden L, Scherer M, Syvänne M, Scholte op RWJ, Vrints C, Wood D, Zamorano JL. Zannad F; European Association for Cardiovascular Prevention & Rehabilitation (EACPR); ESC Committee for Practice Guidelines (CPG). European Guidelines on cardiovascular disease prevention in clinical practice (version 2012). The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts). Eur Heart J. 2012;33:1635–701.PubMedCrossRef
8.
Zurück zum Zitat Díaz-Buschmann I, Jaureguizar KV, Calero MJ, Aquino RS. Programming exercise intensity in patients on beta-blocker treatment: the importance of choosing an appropriate method. Eur J Prev Cardiol. 2013 Aug 5; Epub ahead of print. PMID: 23918838. Díaz-Buschmann I, Jaureguizar KV, Calero MJ, Aquino RS. Programming exercise intensity in patients on beta-blocker treatment: the importance of choosing an appropriate method. Eur J Prev Cardiol. 2013 Aug 5; Epub ahead of print. PMID: 23918838.
9.
Zurück zum Zitat Sixt S, Beer S, Blüher M, et al. Long- but not short-term multifactorial intervention with focus on exercise training improves coronary endothelial dysfunction in diabetes mellitus type 2 and coronary artery disease. Eur Heart J. 2010;31(1):112–9.PubMedCrossRef Sixt S, Beer S, Blüher M, et al. Long- but not short-term multifactorial intervention with focus on exercise training improves coronary endothelial dysfunction in diabetes mellitus type 2 and coronary artery disease. Eur Heart J. 2010;31(1):112–9.PubMedCrossRef
10.
Zurück zum Zitat Niebauer J, Hambrecht R, Velich T, et al. Attenuated progression of coronary artery disease after 6 years of multifactorial risk intervention: role of physical exercise. Circulation. 1997;96:2534–41.PubMedCrossRef Niebauer J, Hambrecht R, Velich T, et al. Attenuated progression of coronary artery disease after 6 years of multifactorial risk intervention: role of physical exercise. Circulation. 1997;96:2534–41.PubMedCrossRef
11.
Zurück zum Zitat Ornish D, Brown SE, Scherwitz LW, et al. Can lifestyle changes reverse coronary heart disease? The Lifestyle Heart Trial. The Lancet. 1990;336(8708):129–33.CrossRef Ornish D, Brown SE, Scherwitz LW, et al. Can lifestyle changes reverse coronary heart disease? The Lifestyle Heart Trial. The Lancet. 1990;336(8708):129–33.CrossRef
12.
Zurück zum Zitat Haskell WL, Alderman EL, Fair JM, et al. Effects of intensive multiple risk factor reduction on coronary atherosclerosis and clinical cardiac events in men and women with coronary artery disease. The Stanford Coronary Risk Intervention Project (SCRIP). Circulation. 1994;89(3):975–90.PubMedCrossRef Haskell WL, Alderman EL, Fair JM, et al. Effects of intensive multiple risk factor reduction on coronary atherosclerosis and clinical cardiac events in men and women with coronary artery disease. The Stanford Coronary Risk Intervention Project (SCRIP). Circulation. 1994;89(3):975–90.PubMedCrossRef
13.
Zurück zum Zitat Khattab A, Knecht M, Meier B, et al. Persistence of uncontrolled cardiovascular risk factors in patients treated with percutaneous interventions for stable coronary artery disease not receiving cardiac rehabilitation. Eur J Prev Cardiol. 2012 Apr. 30; Epub ahead of print. Khattab A, Knecht M, Meier B, et al. Persistence of uncontrolled cardiovascular risk factors in patients treated with percutaneous interventions for stable coronary artery disease not receiving cardiac rehabilitation. Eur J Prev Cardiol. 2012 Apr. 30; Epub ahead of print.
14.
Zurück zum Zitat Corrà U, Piepoli MF, Carré F, et al. Secondary prevention through cardiac rehabilitation: physical activity counselling and exercise training: key components of the position paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation. Eur Heart J. 2010;31(16):1967–74.PubMedCrossRef Corrà U, Piepoli MF, Carré F, et al. Secondary prevention through cardiac rehabilitation: physical activity counselling and exercise training: key components of the position paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation. Eur Heart J. 2010;31(16):1967–74.PubMedCrossRef
15.
Zurück zum Zitat Smith SC Jr, Benjamin EJ, Bonow RO, et al. AHA/ACCF secondary prevention and risk reduction therapy for patients with coronary and other atherosclerotic vascular disease: 2011 update. Circulation. 2011;124:2458–73.PubMedCrossRef Smith SC Jr, Benjamin EJ, Bonow RO, et al. AHA/ACCF secondary prevention and risk reduction therapy for patients with coronary and other atherosclerotic vascular disease: 2011 update. Circulation. 2011;124:2458–73.PubMedCrossRef
16.
Zurück zum Zitat Müller R, Kullich W, Graninger U, et al. Stationäre kardiologische Rehabilitation in Österreich: Ergebnisse einer prospektiven Studie zu den kardiovaskulären Risikofaktoren in der Sekundärprävention. J Kardiol. 2009;16(1–2):14–8. Müller R, Kullich W, Graninger U, et al. Stationäre kardiologische Rehabilitation in Österreich: Ergebnisse einer prospektiven Studie zu den kardiovaskulären Risikofaktoren in der Sekundärprävention. J Kardiol. 2009;16(1–2):14–8.
17.
Zurück zum Zitat Willich SN, Müller-Nordhorn J, Kulig M, et al. Cardiac risk factors, medication, and recurrent clinical events after acute coronary disease; a prospective cohort study. Eur Heart J. 2001;22(4):307–13.PubMedCrossRef Willich SN, Müller-Nordhorn J, Kulig M, et al. Cardiac risk factors, medication, and recurrent clinical events after acute coronary disease; a prospective cohort study. Eur Heart J. 2001;22(4):307–13.PubMedCrossRef
18.
Zurück zum Zitat Berent R, von Duvillard SP, Auer J, Sinzinger H, Schmid P. Lack of supervision after residential cardiac rehabilitation increases cardiovascular risk factors. Eur J Cardiovasc Prev Rehabil. 2010;17(3):296–302.PubMed Berent R, von Duvillard SP, Auer J, Sinzinger H, Schmid P. Lack of supervision after residential cardiac rehabilitation increases cardiovascular risk factors. Eur J Cardiovasc Prev Rehabil. 2010;17(3):296–302.PubMed
19.
Zurück zum Zitat Berent R, von Duvillard SP, Crouse SF, et al. Discontinuation of combined resistance-endurance training increases cardiovascular risk factors. Int J Cardiol. 2012;156(2):229–31.PubMedCrossRef Berent R, von Duvillard SP, Crouse SF, et al. Discontinuation of combined resistance-endurance training increases cardiovascular risk factors. Int J Cardiol. 2012;156(2):229–31.PubMedCrossRef
20.
Zurück zum Zitat Mittag O, Schramm S, Böhmen S, Hüppe A, Meyer T, Raspe H. Medium-term effects of cardiac rehabilitation in Germany: systematic review and meta-analysis of results from national and international trials. Eur J Cardiovasc Prev Rehabil. 2011;18(4):587–93.PubMedCrossRef Mittag O, Schramm S, Böhmen S, Hüppe A, Meyer T, Raspe H. Medium-term effects of cardiac rehabilitation in Germany: systematic review and meta-analysis of results from national and international trials. Eur J Cardiovasc Prev Rehabil. 2011;18(4):587–93.PubMedCrossRef
21.
Zurück zum Zitat Martin BJ, Hauer T, Arena R, et al. Cardiac rehabilitation attendance and outcomes in coronary artery disease patients. Circulation. 2012;126:677–87.PubMedCrossRef Martin BJ, Hauer T, Arena R, et al. Cardiac rehabilitation attendance and outcomes in coronary artery disease patients. Circulation. 2012;126:677–87.PubMedCrossRef
22.
Zurück zum Zitat Lee CD, Jackson AS, Blair SN. US weight guidelines: is it also important to consider cardiorespiratory fitness? Int J Obes Relat Metab Disord. 1998;22:S2–7.PubMed Lee CD, Jackson AS, Blair SN. US weight guidelines: is it also important to consider cardiorespiratory fitness? Int J Obes Relat Metab Disord. 1998;22:S2–7.PubMed
Metadaten
Titel
Long-term effects of outpatient cardiac rehabilitation in Austria: a nationwide registry
verfasst von
Prof. Josef Niebauer, MD, PhD, MBA
Karl Mayr, MD
Hanns Harpf, MD
Peter Hofmann, PhD
Edith Müller, PhD
Manfred Wonisch, MD
Rochus Pokan, MD
Werner Benzer, MD
Publikationsdatum
01.03.2014
Verlag
Springer Vienna
Erschienen in
Wiener klinische Wochenschrift / Ausgabe 5-6/2014
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671
DOI
https://doi.org/10.1007/s00508-014-0527-3

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