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Cardiac Rehabilitation and Adverse Events Among Adult Patients with Simple Congenital Heart Disease and Heart Failure

Buckley, BJR, Kerstens, TP, France-Ratcliffe, M, Lip, GYH and Thijssen, DHJ (2024) Cardiac Rehabilitation and Adverse Events Among Adult Patients with Simple Congenital Heart Disease and Heart Failure. American Journal of Preventive Cardiology. p. 100677. ISSN 2666-6677

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Abstract

Aims Improved care has resulted in prolonged survival of patients with congenital heart disease (ConHD), increasing age-related cardiovascular comorbidities. Although cardiovascular rehabilitation (CR) represents evidence-based care for heart failure (HF), the clinical impact of CR in patients with ConHD who developed HF during adulthood is unclear. We investigated 12-month mortality and morbidity in patients with simple ConHD diagnosed with HF with CR versus without CR. Methods A retrospective cohort study was conducted for the time period February 2004 - February 2024. Utilizing TriNetX, a global federated health research network, a real-world dataset of simple ConHD patients was acquired to compare patients with vs. without (controls) prescription for exercise-based CR. Patients were propensity-score matched for age, sex, ethnicity, comorbidities, procedures, and medication. The primary outcome was a composite of all-cause mortality, ischemic stroke, and acute coronary syndrome (major adverse cardiovascular events; MACE) within 12 months. Results Following propensity score matching, the total cohort consisted of 6,866 simple ConHD patients with HF. CR was associated with significantly lower odds for MACE (odds ratio (OR) 0.61 [95% confidence interval (CI): 0.54–0.69]) and its individual components all-cause mortality (OR 0.40 [95% CI 0.33–0.47]) and ischemic stroke (OR 0.75 [95% CI 0.64–0.88]), but not acute coronary syndrome (OR 1.24 [95% CI 0.91–1.69]). Conclusion CR was associated with significantly lower 12-month MACE in patients with simple ConHD with concomitant HF compared to usual care.

Item Type: Article
Subjects: R Medicine > RA Public aspects of medicine
R Medicine > RC Internal medicine > RC1200 Sports Medicine
Divisions: Nursing & Allied Health
Sport & Exercise Sciences
Publisher: Elsevier
SWORD Depositor: A Symplectic
Date Deposited: 09 May 2024 11:46
Last Modified: 09 May 2024 11:46
DOI or ID number: 10.1016/j.ajpc.2024.100677
URI: https://researchonline.ljmu.ac.uk/id/eprint/23217
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