MEdical TReatment Optimization in cardiac rehabilitation (METRO study) : a French multicenter study.
capacitéfonctionnelle
cardiac rehabilitation
coronary patients
entraînement physique
exercise training
medical treatment
patients coronariens
physical capacity
réadaptationcardiaque
traitementmédical
Journal
Annales de cardiologie et d'angeiologie
ISSN: 1768-3181
Titre abrégé: Ann Cardiol Angeiol (Paris)
Pays: France
ID NLM: 0142167
Informations de publication
Date de publication:
Nov 2021
Nov 2021
Historique:
received:
24
08
2021
accepted:
28
08
2021
pubmed:
13
10
2021
medline:
15
12
2021
entrez:
12
10
2021
Statut:
ppublish
Résumé
Cardiac rehabilitation (CR) is the right place to optimize the medical treatment in coronary artery disease (CAD) patients. To report the medical management in CAD patients during CR and evaluate the consequences. CAD patients who attended a CR program within less than three months of an acute coronary syndrome (ACS), a percutaneous coronary intervention (PCI), or a coronary artery bypass graft (CABG) were included in a prospective multicenter study. Medical treatments were analyzed at the beginning and at discharge of the CR stay. Results of exercise tests were compared between 4 groups. G1: unchanged medication, n=443, G2: beta-blockers or bradycardic agents adaptation n=199, G3: renin-angiotensin system (RAS) inhibitors adaptation, n=194, G4: both medications adaptation, n=164. One thousand consecutive patients were included in 23 French CR centers (85.3% males; mean age 59.9 ± 11 years). The index event was ACS (68.5%), PCI (62.6%) and CABG (36.3%). During CR, we noted an adaptation for beta-blockers in 32.1%, in other bradycardic agents (ivabradine, verapamil, diltiazem, amiodarone) in 9.5%, and in RAS inhibitors in 36.3%. Patients of group 1 had an initial resting heart rate lower than in group 2 and 4, but at the final exercise testing, the range of the decrease was more important in group 2 and 4. The combination of physical training and therapeutic modifications resulted in similar exercise capacities in the four groups, from 5.2, 5.3, 5.4 and 5.2 MET (p=0.68), to 6.3, 6.5, 6.5 and 6.1 MET (p=0.44), respectively. The METRO study showed that significant alteration in medical treatment during cardiac rehabilitation programs could take part in improving physical capacity.
Sections du résumé
BACKGROUND
BACKGROUND
Cardiac rehabilitation (CR) is the right place to optimize the medical treatment in coronary artery disease (CAD) patients.
AIMS
OBJECTIVE
To report the medical management in CAD patients during CR and evaluate the consequences.
METHODS
METHODS
CAD patients who attended a CR program within less than three months of an acute coronary syndrome (ACS), a percutaneous coronary intervention (PCI), or a coronary artery bypass graft (CABG) were included in a prospective multicenter study. Medical treatments were analyzed at the beginning and at discharge of the CR stay. Results of exercise tests were compared between 4 groups. G1: unchanged medication, n=443, G2: beta-blockers or bradycardic agents adaptation n=199, G3: renin-angiotensin system (RAS) inhibitors adaptation, n=194, G4: both medications adaptation, n=164.
RESULTS
RESULTS
One thousand consecutive patients were included in 23 French CR centers (85.3% males; mean age 59.9 ± 11 years). The index event was ACS (68.5%), PCI (62.6%) and CABG (36.3%). During CR, we noted an adaptation for beta-blockers in 32.1%, in other bradycardic agents (ivabradine, verapamil, diltiazem, amiodarone) in 9.5%, and in RAS inhibitors in 36.3%. Patients of group 1 had an initial resting heart rate lower than in group 2 and 4, but at the final exercise testing, the range of the decrease was more important in group 2 and 4. The combination of physical training and therapeutic modifications resulted in similar exercise capacities in the four groups, from 5.2, 5.3, 5.4 and 5.2 MET (p=0.68), to 6.3, 6.5, 6.5 and 6.1 MET (p=0.44), respectively.
CONCLUSION
CONCLUSIONS
The METRO study showed that significant alteration in medical treatment during cardiac rehabilitation programs could take part in improving physical capacity.
Identifiants
pubmed: 34635328
pii: S0003-3928(21)00098-6
doi: 10.1016/j.ancard.2021.08.009
pii:
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
275-280Informations de copyright
Copyright © 2021 Elsevier Masson SAS. All rights reserved.
Déclaration de conflit d'intérêts
Conflict of interest None