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Exercise-Based Cardiac Rehabilitation Associates with Lower Major Adverse Cardiovascular Events in People with Stroke

Buckley, BJR, Harrison, SL, Fazio-Eynullayeva, E, Underhill, P, Lane, DA, Thijssen, DHJ and Lip, GYH (2021) Exercise-Based Cardiac Rehabilitation Associates with Lower Major Adverse Cardiovascular Events in People with Stroke. Cerebrovascular Diseases. ISSN 1015-9770

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Background: The risk of major adverse cardiovascular events is substantially increased following a stroke. Although exercise-based cardiac rehabilitation has been shown to improve prognosis following cardiac events, it is not part of routine care for people following a stroke. We therefore investigated the association between cardiac rehabilitation and major adverse cardiovascular events for people with stroke.
Methods: This retrospective analysis was conducted on June 20, 2021, using anonymized data within TriNetX, a global federated health research network with access to electronic medical records from participating healthcare organizations, predominantly in the USA. All participants were aged ≥18 years with cerebrovascular disease and at least 2 years of follow-up. People with stroke and an electronic medical record of exercise-based cardiac rehabilitation were 1:1 propensity score matched to people with stroke but without cardiac rehabilitation using participant characteristics, comorbidities, cardiovascular procedures, and cardiovascular medications.
Results: Of 836,923 people with stroke and 2-year follow-up, 2,909 met the inclusion for the exercise-based cardiac rehabilitation cohort. Following propensity score matching (n = 5,818), exercise-based cardiac rehabilitation associated with 53% lower odds of all-cause mortality (odds ratio 0.47, 95% confidence interval: 0.40–0.56), 12% lower odds of recurrent stroke (0.88, 0.79–0.98), and 36% lower odds of rehospitalization (0.64, 0.58–0.71), compared to controls. No significant association between cardiac rehabilitation and incident atrial fibrillation was observed.
Conclusion: Exercise-based cardiac rehabilitation prescribed for people following a stroke associated with significantly lower odds of major adverse cardiovascular events at 2 years, compared to usual care.

Item Type: Article
Uncontrolled Keywords: 1103 Clinical Sciences, 1109 Neurosciences
Subjects: R Medicine > RC Internal medicine > RC1200 Sports Medicine
Divisions: Sport & Exercise Sciences
Publisher: Karger
Related URLs:
Date Deposited: 11 Jan 2022 12:16
Last Modified: 11 Jan 2022 12:30
DOI or ID number: 10.1159/000521025
URI: https://researchonline.ljmu.ac.uk/id/eprint/16022
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