Hospital-based comprehensive cardiac rehabilitation versus usual care among patients with congestive heart failure, ischemic heart disease, or high risk of ischemic heart disease: 12-month results of a randomized clinical trial.

Ann-Dorthe Olsen Zwisler; Anne Merete Boas Soja; Søren Rasmussen; Marianne Frederiksen; Sadollah Abadini; Jon Appel; Hanne Rasmussen; Christian Gluud; Lars Iversen; Bjarne Sigurd; Mette Madsen; Jørgen Fischer-Hansen; DANREHAB Group

doi:10.1016/j.ahj.2007.12.033

Hospital-based comprehensive cardiac rehabilitation versus usual care among patients with congestive heart failure, ischemic heart disease, or high risk of ischemic heart disease: 12-month results of a randomized clinical trial.

Ann-Dorthe Olsen Zwisler, Anne Merete Boas Soja, Søren Rasmussen, Marianne Frederiksen, Sadollah Abadini, Jon Appel, Hanne Rasmussen, Christian Gluud, Lars Iversen, Bjarne Sigurd, Mette Madsen, Jørgen Fischer-Hansen, DANREHAB Group

57 Citations (Scopus)

Abstract

BACKGROUND: Current guidelines broadly recommend comprehensive cardiac rehabilitation (CCR), although evidence for this is still limited. We investigated the 12-month effect of hospital-based CCR versus usual care (UC) for a broadly defined group of cardiac patients within the modern therapeutic era of cardiology. METHODS: We conducted a centrally randomized single-center clinical trial with blinded assessment of the primary outcome: registry-based composite of total mortality, myocardial infarction, or acute first-time readmission due to heart disease. Other outcomes were hospitalization, risk profile, and quality of life. The trial included 770 participants (20-94 years) with congestive heart failure (12%), ischemic heart disease (58%), or high risk of ischemic heart disease (30%). Comprehensive cardiac rehabilitation is composed of 6 weeks of intensive intervention and systematic follow-up for 10.5 months. RESULTS: We randomized 380 patients to CCR versus 390 to UC. Randomization was well balanced. The primary outcome occurred in 31% of both groups (relative risk 0.96, 95% confidence interval 0.78-1.26). Compared with the UC group, CCR significantly reduced length of stay by 15% (95% confidence interval 1.1%-27.1%, P = .04), mean number of cardiac risk factors above target (4.5 vs 4.1, P = .01), patients with systolic blood pressure below target (P = .003), physically inactivity (P = .01), and unhealthy dietary habits (P = .0003). Short-Form-36 and Hospital Anxiety and Depression Scale did not differ significantly. CONCLUSION: At 12 months, the CCR and UC groups did not differ regarding the primary composite outcome. Comprehensive cardiac rehabilitation significantly reduced length of hospital stay and improved cardiac risk factors.

Original language	English
Journal	American Heart Journal
Volume	155
Issue number	6
Pages (from-to)	1106-13
Number of pages	7
ISSN	0002-8703
DOIs	https://doi.org/10.1016/j.ahj.2007.12.033
Publication status	Published - 2008

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Zwisler, A-D. O., Soja, A. M. B., Rasmussen, S., Frederiksen, M., Abadini, S., Appel, J., Rasmussen, H., Gluud, C., Iversen, L., Sigurd, B., Madsen, M., Fischer-Hansen, J., & DANREHAB Group (2008). Hospital-based comprehensive cardiac rehabilitation versus usual care among patients with congestive heart failure, ischemic heart disease, or high risk of ischemic heart disease: 12-month results of a randomized clinical trial. American Heart Journal, 155(6), 1106-13. https://doi.org/10.1016/j.ahj.2007.12.033

Hospital-based comprehensive cardiac rehabilitation versus usual care among patients with congestive heart failure, ischemic heart disease, or high risk of ischemic heart disease: 12-month results of a randomized clinical trial. / Zwisler, Ann-Dorthe Olsen; Soja, Anne Merete Boas; Rasmussen, Søren et al.

In: American Heart Journal, Vol. 155, No. 6, 2008, p. 1106-13.

Research output: Contribution to journal › Journal article › Research › peer-review

Zwisler, A-DO, Soja, AMB, Rasmussen, S, Frederiksen, M, Abadini, S, Appel, J, Rasmussen, H, Gluud, C, Iversen, L, Sigurd, B, Madsen, M, Fischer-Hansen, J & DANREHAB Group 2008, 'Hospital-based comprehensive cardiac rehabilitation versus usual care among patients with congestive heart failure, ischemic heart disease, or high risk of ischemic heart disease: 12-month results of a randomized clinical trial.', American Heart Journal, vol. 155, no. 6, pp. 1106-13. https://doi.org/10.1016/j.ahj.2007.12.033

Zwisler A-DO, Soja AMB, Rasmussen S, Frederiksen M, Abadini S, Appel J et al. Hospital-based comprehensive cardiac rehabilitation versus usual care among patients with congestive heart failure, ischemic heart disease, or high risk of ischemic heart disease: 12-month results of a randomized clinical trial. American Heart Journal. 2008;155(6):1106-13. doi: 10.1016/j.ahj.2007.12.033

Zwisler, Ann-Dorthe Olsen ; Soja, Anne Merete Boas ; Rasmussen, Søren et al. / Hospital-based comprehensive cardiac rehabilitation versus usual care among patients with congestive heart failure, ischemic heart disease, or high risk of ischemic heart disease: 12-month results of a randomized clinical trial. In: American Heart Journal. 2008 ; Vol. 155, No. 6. pp. 1106-13.

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title = "Hospital-based comprehensive cardiac rehabilitation versus usual care among patients with congestive heart failure, ischemic heart disease, or high risk of ischemic heart disease: 12-month results of a randomized clinical trial.",

abstract = "BACKGROUND: Current guidelines broadly recommend comprehensive cardiac rehabilitation (CCR), although evidence for this is still limited. We investigated the 12-month effect of hospital-based CCR versus usual care (UC) for a broadly defined group of cardiac patients within the modern therapeutic era of cardiology. METHODS: We conducted a centrally randomized single-center clinical trial with blinded assessment of the primary outcome: registry-based composite of total mortality, myocardial infarction, or acute first-time readmission due to heart disease. Other outcomes were hospitalization, risk profile, and quality of life. The trial included 770 participants (20-94 years) with congestive heart failure (12%), ischemic heart disease (58%), or high risk of ischemic heart disease (30%). Comprehensive cardiac rehabilitation is composed of 6 weeks of intensive intervention and systematic follow-up for 10.5 months. RESULTS: We randomized 380 patients to CCR versus 390 to UC. Randomization was well balanced. The primary outcome occurred in 31% of both groups (relative risk 0.96, 95% confidence interval 0.78-1.26). Compared with the UC group, CCR significantly reduced length of stay by 15% (95% confidence interval 1.1%-27.1%, P = .04), mean number of cardiac risk factors above target (4.5 vs 4.1, P = .01), patients with systolic blood pressure below target (P = .003), physically inactivity (P = .01), and unhealthy dietary habits (P = .0003). Short-Form-36 and Hospital Anxiety and Depression Scale did not differ significantly. CONCLUSION: At 12 months, the CCR and UC groups did not differ regarding the primary composite outcome. Comprehensive cardiac rehabilitation significantly reduced length of hospital stay and improved cardiac risk factors.",

author = "Zwisler, {Ann-Dorthe Olsen} and Soja, {Anne Merete Boas} and S{\o}ren Rasmussen and Marianne Frederiksen and Sadollah Abadini and Jon Appel and Hanne Rasmussen and Christian Gluud and Lars Iversen and Bjarne Sigurd and Mette Madsen and J{\o}rgen Fischer-Hansen and {DANREHAB Group}",

note = "Keywords: Adult; Aged; Aged, 80 and over; Female; Heart Failure; Hospitalization; Humans; Male; Middle Aged; Myocardial Ischemia; Risk Factors; Severity of Illness Index",

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doi = "10.1016/j.ahj.2007.12.033",

language = "English",

volume = "155",

pages = "1106--13",

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T1 - Hospital-based comprehensive cardiac rehabilitation versus usual care among patients with congestive heart failure, ischemic heart disease, or high risk of ischemic heart disease: 12-month results of a randomized clinical trial.

AU - Zwisler, Ann-Dorthe Olsen

AU - Soja, Anne Merete Boas

AU - Rasmussen, Søren

AU - Frederiksen, Marianne

AU - Abadini, Sadollah

AU - Appel, Jon

AU - Rasmussen, Hanne

AU - Gluud, Christian

AU - Iversen, Lars

AU - Sigurd, Bjarne

AU - Madsen, Mette

AU - Fischer-Hansen, Jørgen

AU - DANREHAB Group

N1 - Keywords: Adult; Aged; Aged, 80 and over; Female; Heart Failure; Hospitalization; Humans; Male; Middle Aged; Myocardial Ischemia; Risk Factors; Severity of Illness Index

PY - 2008

Y1 - 2008

N2 - BACKGROUND: Current guidelines broadly recommend comprehensive cardiac rehabilitation (CCR), although evidence for this is still limited. We investigated the 12-month effect of hospital-based CCR versus usual care (UC) for a broadly defined group of cardiac patients within the modern therapeutic era of cardiology. METHODS: We conducted a centrally randomized single-center clinical trial with blinded assessment of the primary outcome: registry-based composite of total mortality, myocardial infarction, or acute first-time readmission due to heart disease. Other outcomes were hospitalization, risk profile, and quality of life. The trial included 770 participants (20-94 years) with congestive heart failure (12%), ischemic heart disease (58%), or high risk of ischemic heart disease (30%). Comprehensive cardiac rehabilitation is composed of 6 weeks of intensive intervention and systematic follow-up for 10.5 months. RESULTS: We randomized 380 patients to CCR versus 390 to UC. Randomization was well balanced. The primary outcome occurred in 31% of both groups (relative risk 0.96, 95% confidence interval 0.78-1.26). Compared with the UC group, CCR significantly reduced length of stay by 15% (95% confidence interval 1.1%-27.1%, P = .04), mean number of cardiac risk factors above target (4.5 vs 4.1, P = .01), patients with systolic blood pressure below target (P = .003), physically inactivity (P = .01), and unhealthy dietary habits (P = .0003). Short-Form-36 and Hospital Anxiety and Depression Scale did not differ significantly. CONCLUSION: At 12 months, the CCR and UC groups did not differ regarding the primary composite outcome. Comprehensive cardiac rehabilitation significantly reduced length of hospital stay and improved cardiac risk factors.

AB - BACKGROUND: Current guidelines broadly recommend comprehensive cardiac rehabilitation (CCR), although evidence for this is still limited. We investigated the 12-month effect of hospital-based CCR versus usual care (UC) for a broadly defined group of cardiac patients within the modern therapeutic era of cardiology. METHODS: We conducted a centrally randomized single-center clinical trial with blinded assessment of the primary outcome: registry-based composite of total mortality, myocardial infarction, or acute first-time readmission due to heart disease. Other outcomes were hospitalization, risk profile, and quality of life. The trial included 770 participants (20-94 years) with congestive heart failure (12%), ischemic heart disease (58%), or high risk of ischemic heart disease (30%). Comprehensive cardiac rehabilitation is composed of 6 weeks of intensive intervention and systematic follow-up for 10.5 months. RESULTS: We randomized 380 patients to CCR versus 390 to UC. Randomization was well balanced. The primary outcome occurred in 31% of both groups (relative risk 0.96, 95% confidence interval 0.78-1.26). Compared with the UC group, CCR significantly reduced length of stay by 15% (95% confidence interval 1.1%-27.1%, P = .04), mean number of cardiac risk factors above target (4.5 vs 4.1, P = .01), patients with systolic blood pressure below target (P = .003), physically inactivity (P = .01), and unhealthy dietary habits (P = .0003). Short-Form-36 and Hospital Anxiety and Depression Scale did not differ significantly. CONCLUSION: At 12 months, the CCR and UC groups did not differ regarding the primary composite outcome. Comprehensive cardiac rehabilitation significantly reduced length of hospital stay and improved cardiac risk factors.

U2 - 10.1016/j.ahj.2007.12.033

DO - 10.1016/j.ahj.2007.12.033

M3 - Journal article

C2 - 18513526

SN - 0002-8703

VL - 155

SP - 1106

EP - 1113

JO - American Heart Journal

JF - American Heart Journal

IS - 6

ER -