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Type:	Artigo de Periódico
Title:	Maintenance of gains, morbidity, and mortality at 1 year following cardiac rehabilitation in a middle-income country: a wait-list control crossover trial
Authors:	Gabriela Suéllen da Silva Chaves Gabriela Lima de Melo Ghisi Raquel Rodrigues Britto Sherry Grace
Abstract:	Background: Despite the epidemic of cardiovascular diseases in middle‐income countries, few trials are testing the benefits of cardiac rehabilitation (CR). This trial assessed (1) maintenance of functional capacity, risk factor control, knowledge, and heart‐health behaviors and (2) mortality and morbidity at 6 months following CR in a middle‐income country. Methods and Results: Eligible Brazilian coronary patients were initially randomized (1:1:1 concealed) to 1 of 3 parallel arms (comprehensive CR [exercise plus education], exercise‐only CR, or wait‐list control). The CR programs were 6 months in duration, at which point follow‐up assessments were performed. Mortality and morbidity were ascertained from chart and patient or family report (blinded). Controls were then offered CR (crossover). Outcomes were again assessed 6 months later (blinded). ANCOVA was performed for each outcome at 12 months. Overall, 115 (88.5%) patients were randomized, and 62 (53.9%) were retained at 1 year. At 6 months, 23 (58.9%) of those 39 initially randomized to the wait‐list control elected to attend CR. Functional capacity, risk factors, knowledge, and heart‐health behaviors were maintained from 6 to 12 months in participants from both CR arms (all P>0.05). At 1 year, knowledge was significantly greater with comprehensive CR at either time point (P<0.001). There were 2 deaths. Hospitalizations (P=0.03), nonfatal myocardial infarctions (P=0.04), and percutaneous coronary interventions (P=0.03) were significantly fewer with CR than control at 6 months. Conclusions: CR participation is associated with lower morbidity, long‐term maintenance of functional capacity, risk factors, and heart‐health behaviors, as well as with greater cardiovascular knowledge compared with no CR.
Subject:	Reabilitação cardíaca Coronariopatias Mortalidade Fatores de risco Países em desenvolvimento
language:	eng
metadata.dc.publisher.country:	Brasil
Publisher:	Universidade Federal de Minas Gerais
Publisher Initials:	UFMG
metadata.dc.publisher.department:	EEF - DEPARTAMENTO DE FISIOTERAPIA
Rights:	Acesso Aberto
metadata.dc.identifier.doi:	https://doi.org/10.1161/JAHA.118.011228
URI:	http://hdl.handle.net/1843/43243
Issue Date:	Feb-2019
metadata.dc.url.externa:	https://www.ahajournals.org/doi/full/10.1161/JAHA.118.011228?rfr_dat=cr_pub++0pubmed&url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org
metadata.dc.relation.ispartof:	Journal of the American Heart Association
Appears in Collections:	Artigo de Periódico

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