Cardiac rehabilitation improves short-term outcomes in HF patients

Cardiac rehabilitation (CR) is standard for the treatment of heart failure (HF) and yields short-term prognostic benefits, a recent study has found. However, long-term benefits remain uncertain.

Researchers conducted a multicentre prospective analysis of 2,876 HF patients, of whom 313 (median age 74 years, 59.1 percent men) underwent CR at least once weekly for 6 months. The primary outcome was a composite of all-cause mortality and HF rehospitalization, observed during 2 years of follow-up. A propensity score-matched parallel group of 313 non-CR HF controls (median age 74 years, 60.1 percent men) was also included.

During the study, 137 patients in the matched cohort were rehospitalized for HF exacerbations and 50 died. The median periods from discharge to the corresponding endpoints were 157 and 410 days. Kaplan-Meier survival curve analysis found that CR patients showed significantly lower rates of both outcomes (log-rank p<0.05).

Cox proportional hazards model analysis confirmed the consistent and significant positive benefits of CR, reducing the risk of the composite outcome by almost 35 percent (hazard ratio [HR], 0.66, 95 percent confidence interval [CI], 0.48–0.91).

CR had similar and significant impacts on the individual components of all-cause mortality (HR, 0.53, 95 percent CI, 0.30–0.95) and HF rehospitalization (HR, 0.66, 95 percent CI, 0.47–0.92).

However, in a subsequent landmark analysis, the researchers found that CR had no significant impact on mortality, rehospitalization, or the composite outcome beyond 6 months after discharge.