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Buckley, BJR, Harrison, SL, Fazio-Eynullayeva, E, Underhill, P, Lane, DA, Thijssen, DHJ and Lip, GYH (2021) Exercise-Based Cardiac Rehabilitation and All-Cause Mortality Among Patients With Atrial Fibrillation. Journal of the American Heart Association, 10 (12). ISSN 2047-9980
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Abstract
Background There is limited evidence of long-term impact of exercise-based cardiac rehabilitation (CR) on clinical end points for patients with atrial fibrillation (AF). We therefore compared 18-month all-cause mortality, hospitalization, stroke, and heart failure in patients with AF and an electronic medical record of exercise-based CR to matched controls. Methods and Results This retrospective cohort study included patient data obtained on February 3, 2021 from a global federated health research network. Patients with AF undergoing exercise-based CR were propensity-score matched to patients with AF without exercise-based CR by age, sex, race, comorbidities, cardiovascular procedures, and cardiovascular medication. We ascertained 18-month incidence of all-cause mortality, hospitalization, stroke, and heart failure. Of 1 366 422 patients with AF, 11 947 patients had an electronic medical record of exercise-based CR within 6-months of incident AF who were propensity-score matched with 11 947 patients with AF without CR. Exercise-based CR was associated with 68% lower odds of all-cause mortality (odds ratio, 0.32; 95% CI, 0.29-0.35), 44% lower odds of rehospitalization (0.56; 95% CI, 0.53-0.59), and 16% lower odds of incident stroke (0.84; 95% CI, 0.72-0.99) compared with propensity-score matched controls. No significant associations were shown for incident heart failure (0.93; 95% CI, 0.84-1.04). The beneficial association of exercise-based CR on all-cause mortality was independent of sex, older age, comorbidities, and AF subtype. Conclusions Exercise-based CR among patients with incident AF was associated with lower odds of all-cause mortality, rehospitalization, and incident stroke at 18-month follow-up, supporting the provision of exercise-based CR for patients with AF.
| Item Type: | Article |
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| Uncontrolled Keywords: | 1102 Cardiorespiratory Medicine and Haematology |
| Subjects: | Q Science > QP Physiology R Medicine > RA Public aspects of medicine R Medicine > RC Internal medicine > RC1200 Sports Medicine |
| Divisions: | Nursing & Allied Health Sport & Exercise Sciences |
| Publisher: | American Heart Association |
| Related URLs: | |
| Date Deposited: | 16 Aug 2021 09:57 |
| Last Modified: | 04 Sep 2021 05:09 |
| DOI or ID number: | 10.1161/JAHA.121.020804 |
| URI: | https://researchonline.ljmu.ac.uk/id/eprint/15365 |
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