Clinical characteristics and course of patients with diabetes entering cardiac rehabilitation - PubMed (original) (raw)

Observational Study

. 2015 Feb;107(2):267-72.

doi: 10.1016/j.diabres.2014.11.006. Epub 2014 Dec 3.

Collaborators, Affiliations

Observational Study

Clinical characteristics and course of patients with diabetes entering cardiac rehabilitation

Francesco Giallauria et al. Diabetes Res Clin Pract. 2015 Feb.

Abstract

Background: Using data from the Italian SurveY on carDiac rEhabilitation (ISYDE-2008), this study provides insight into the level of implementation of Cardiac Rehabilitation (CR) in patients with diabetes.

Methods: Data from 165 CR units were collected online from January 28th to February 10th, 2008.

Results: The study cohort consisted of 2281 patients (66.9 ± 12 yrs); 475 (69.7 ± 10 yrs, 74% male) patients with diabetes and 1806 (66.2 ± 12 yrs, 72% male) non-diabetic patients. Compared to non-diabetic patients, patients with diabetes were older and showed more comorbidity [myocardial infarction (32% vs. 19%, p < 0.0001), peripheral artery disease (10% vs. 5%, p < 0.0001), chronic obstructive pulmonary disease (20% vs. 11%, p < 0.0001), chronic kidney disease (20% vs. 6%, p < 0.0001), and cognitive impairment (5% vs. 2%, p = 0.0009), respectively], and complications during CR [re-infarction (3% vs. 1%, p = 0.04), acute renal failure (9% vs. 4%, p < 0.0001), sternal revision (3% vs. 1%, p = 0.01), inotropic support/mechanical assistance (7% vs. 4%, p = 0.01), respectively]; a more complex clinical course and interventions with less functional evaluation and a different pattern of drug therapy at hospital discharge. Notably, in 51 (3%) and in 104 (6%) of the non-diabetic cohort, insulin and hypoglycemic agents were prescribed, respectively, at hospital discharge from CR suggesting a careful evaluation of the glycemic metabolism during CR program, independent of the diagnosis at the admission. Mortality was similar among diabetic compared to non-diabetic patients (1% vs. 0.5%, p = 0.23).

Conclusions: This survey provided a detailed overview of the clinical characteristics, complexity and more severe clinical course of diabetic patients admitted to CR.

Keywords: Cardiac rehabilitation; Cardiopulmonary exercise testing; Chronic heart failure; Diabetes; Exercise training; Myocardial infarction.

Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

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