Active Participation in Outpatient Cardiac Rehabilitation Is Associated With Better Prognosis After Coronary Artery Bypass Graft Surgery　― J-REHAB CABG Study ―

• Origuchi Hideki

  Department of Internal Medicine, Japan Community Healthcare Organization Kyushu Hospital

• Itoh Haruki

  Sakakibara Heart Institute

• Momomura Shin-ichi

  Cardiovascular Center, Jichi Medical University Saitama Medical Center

• Nohara Ryuji

  Hirakata Kohsai Hospital

• Daida Hiroyuki

  Department of Cardiology, Juntendo University Graduate School of Medicine

• Masuda Takashi

  Department of Angiology and Cardiology, Kitasato University Graduate School of Medical Sciences

• Kohzuki Masahiro

  Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine

• Makita Shigeru

  Department of Cardiac Rehabilitation, Saitama International Medical Center, Saitama Medical University

• Ueshima Kenji

  Department of EBM Research, Institute for Advancement of Clinical Research and Translational Science, Kyoto University Hospital

• Nagayama Masatoshi

  Department of Cardiology, Sakakibara Heart Institute

• Omiya Kazuto

  St. Marianna University School of Medicine

• Adachi Hitoshi

  Department of Cardiology, Gunma Prefectural Cardiovascular Center

• Goto Yoichi

  Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center

抄録

Background:There is little evidence regarding the effect of outpatient cardiac rehabilitation (CR) on exercise capacity or the long-term prognosis in patients after coronary artery bypass graft surgery (CABG). This study aimed to determine whether participation in outpatient CR improves exercise capacity and long-term prognosis in post-CABG Japanese patients in a multicenter cohort. Methods and Results:We enrolled 346 post-CABG patients who underwent cardiopulmonary exercise testing during early (2–3 weeks) and late (3–6 months) time points after surgery. They formed the Active (n=240) and Non-Active (n=106) CR participation groups and were followed for 3.5 years. Primary endpoint was a major adverse cardiac event (MACE): all-cause death or rehospitalization for acute myocardial infarction/unstable angina/worsening heart failure. Peak oxygen uptake at 3–5 months from baseline was significantly more increased in Active than in Non-Active patients (+26±24% vs. +19±20%, respectively; P<0.05), and the MACE rate was significantly lower in Active than Non-Active patients (3.4% vs. 10.5%, respectively; P=0.02). Multivariate Cox proportional hazard analysis showed that participation in outpatient CR was a significant prognostic determinant of MACE (P=0.03). Conclusions:This unique study showed that a multicenter cohort of patients who underwent CABG and actively participated in outpatient CR exhibited greater improvement in exercise capacity and better survival without cardiovascular events than their counterparts who did not participate.

収録刊行物

• Circulation Journal

  Circulation Journal 84 (3), 427-435, 2020-02-25

  一般社団法人 日本循環器学会

キーワード

• Coronary artery bypass graft surgery
• Exercise capacity
• Long-term prognosis
• Outpatient cardiac rehabilitation

詳細情報

• CRID: 1390846609807571072
• NII論文ID: 130007801766
• NII書誌ID: AA11591968
• DOI: 10.1253/circj.cj-19-0650
• ISSN: 13474820
• ISSN: 13469843
• NDL書誌ID: 030281923
• PubMed: 32037378
• Web Site: https://ndlsearch.ndl.go.jp/books/R000000004-I030281923
• Web Site: https://www.jstage.jst.go.jp/article/circj/84/3/84_CJ-19-0650/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2020287959
• 本文言語コード: en
• データソース種別:
  • JaLC
  • NDL
  • Crossref
  • PubMed
  • CiNii Articles
  • KAKEN
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