Cardiac rehabilitation fitness changes and subsequent survival

Assessments of cardiac rehabilitation (CR) in coronary heart disease (CHD) cohorts usually examine mortality in aggregate. The current study examines the prognosis and characteristics of patients who enrolled and completed CR, stratified by their level of improvement in cardiorespiratory fitness (CRF) by examining the characteristics, outcomes and predictors of non-response in CRF (NonRes) compared to low-responders (LowRes) and high-Responders (HighRes) after CR.1171 CHD patients were referred for a phase II CR program after therapy for an acute coronary syndrome, coronary artery bypass graft procedure or a percutaneous coronary intervention between January 1, 2000 and June 30, 2013 underwent cardiopulmonary exercise testing before and after CR. This cohort was divided according to absolute improvements in CRF [i.e., change in peak oxygen consumption expressed in ml•kg-1•min-1]. Mortality was analyzed after 0.5 to 13.4 years of follow-up (mean 6.4 years). 266 (23%) of subjects were NonRes. After adjustment for body mass index, age, gender, left ventricular ejection fraction and baseline CRF, NonRes and LowRes had a statistically significant 3-fold and 2-fold higher mortality, respectively, when compared to HighRes (HighRes: 8% vs LowRes: 17% vs NonRes: 22%; p