Entering Cardiac Rehabilitation With Peripheral Artery Disease: A RETROSPECTIVE COMPARISON TO CORONARY ARTERY DISEASE. Issue 4 (July 2020)

• Record Type: Journal Article
• Authors: Nguyen, Cindy H.; Marzolini, Susan; Oh, Paul; Thomas, Scott G.
• Is Part Of: Journal of cardiopulmonary rehabilitation and prevention. Volume 40:Issue 4(2020)
• Publication Date: 2020-07
• Subjects: cardiac rehabilitation -- cardiorespiratory fitness -- coronary artery disease -- peripheral artery disease; Cardiopulmonary system -- Diseases -- Patients -- Rehabilitation -- Periodicals; Cardiopulmonary system -- Diseases -- Prevention -- Periodicals; 616.103
• DOI: 10.1097/HCR.0000000000000475
• Languages: English
• ISSNs: 1932-7501

Abstract

Abstract : Purpose: Supervised exercise is recommended for patients with peripheral artery disease (PAD) and patients with coronary artery disease (CAD). Both conditions share common etiology as atherosclerotic diseases. The clinical profile, cardiorespiratory fitness, and exercise prescriptions of PAD, CAD, and patients with concomitant PAD and CAD (BOTH) have yet to be compared upon entry into cardiac rehabilitation (CR). Methods: Cardiopulmonary, demographic, and anthropometric assessments were conducted at entry to CR between January 2006 and December 2017. Results: Among 9701 consecutively enrolled patients, there were 94.6% with CAD (n = 9179), 1.5% with PAD (n = 143), and 3.9% with BOTH (n = 379). Only 5.4% (n = 522) of all patients entering CR had a diagnosis of PAD. Compared with CAD, patients with PAD and BOTH were older (mean ± SD = 62.5 ± 11.1 vs 67.9 ± 11.4 and 69.2 ± 9.8 yr, P < .01), had higher resting systolic blood pressure (124 ± 17 vs 130 ± 17 and 133 ± 18 mm Hg, P < .01), had lower cardiorespiratory fitness (19.7 ± 6.3 vs 15.6 ± 4.8 and 15 ± 4.5 mL/kg/min, P < .01), and were more likely to have diabetes (25% vs 35% and 41%, P < .01), abdominal obesity (39% vs 54% and 51%, P < .01), and initially prescribed lower-intensity exercise (84.4 ± 14.1 vs 74.1 ± 15.7 and 70.0 ± 14.6 m/min exercise pace, P < .01), reflecting the complex nature of patients diagnosed with PAD. Conclusions: Patients referred with PAD have a cardiovascular risk profile that places them at a greater risk for a repeat or first cardiac event compared with patients with CAD. Referral to structured exercise and risk factor modification programs should be considered to aid in the management of PAD. Abstract : Patients with peripheral artery disease enter cardiac rehabilitation (CR) at a greater risk for a repeat or first cardiac event compared with patients with coronary artery disease, being older, having higher resting systolic blood pressure, and having lower fitness. Patients with peripheral artery disease can be evaluated and prescribed exercise within standard CR programs.