Cardiac Rehabilitation and Long-Term Prognosis in Cardiovascular Disease Patients with Cancer History
Takashi Miki, Kentaro Kamiya, Kensuke Ueno, Nobuaki Hamazaki, Kohei Nozaki, Shota Uchida, Takumi Noda, Ken Ogura, Kazuki Hotta, Emi Maekawa, Jiichiro Sasaki, Minako Yamaoka-Tojo, Atsuhiko Matsunaga, Junya AkoAbstract
Background
Cancer and cardiovascular disease (CVD) share common risk factors, and the development of CVD in cancer survivors is a significant event that worsens prognosis. Comprehensive cardiac rehabilitation (CR) has been reported to be associated with improved prognosis, including risk of death and rehospitalisation, in patients with CVD. However, the benefits of CR to patients with both cancer and CVD is unclear.
Aims
This study aimed to investigate the usefulness of CR in CVD patients with cancer history.
Methods
We retrospectively reviewed 1,424 CVD patients with a cancer history (median age: 76 [69–81] years). Primary and secondary outcomes were all-cause mortality and composite events of all-cause death and CVD-related rehospitalisation, respectively. CR participation was defined as attending rehabilitation at least once within three months of discharge. We performed propensity score (PS) matching for CR, followed by Cox regression analysis, to assess the association between CR and prognosis.
Results
During the median follow-up period of 1.8 (0.7–3.4) years, 286 deaths and 465 composite events occurred. After PS matching, 1,008 patients (504 pairs) were included, with standardised mean differences of < 0.1 for all covariates. CR participation was associated with a significantly lower risk of all-cause mortality (Hazard ratio [HR]: 0.54, 95% confidence interval [CI]: 0.41–0.73, P < 0.001) and composite event rates (HR: 0.62, 95% CI: 0.50–0.78, P < 0.001) compared to CR non-participation.
Conclusion
CR participation was associated with a lower risk of poor prognostic events in CVD patients with a history of cancer.