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Cardiometabolic responses to cardiac rehabilitation in people with and without diabetes

Published on Feb 15, 2020in International Journal of Cardiology3.471
· DOI :10.1016/j.ijcard.2019.11.134
Deepika Laddu7
Estimated H-index: 7
(UIC: University of Illinois at Chicago),
Cemal Ozemek10
Estimated H-index: 10
(UIC: University of Illinois at Chicago)
+ 6 AuthorsRoss Arena57
Estimated H-index: 57
(UIC: University of Illinois at Chicago)
Abstract
Abstract Background Type 2 diabetes and cardiometabolic comorbidities manifesting as the metabolic syndrome (MetS) are highly prevalent in coronary heart disease (CHD) patients attending cardiac rehabilitation (CR). The study aimed to determine the prevalence of cardiometabolic derangements and MetS, and compare post-CR clinical responses in a large cohort of CHD patients with and without diabetes. Methods Analyses were conducted on 3953 CHD patients [age: 61.1 ± 10.5 years; 741 (18.7%) with diabetes] that completed a representative 12-week CR program. A propensity model was used to match patients with diabetes (n = 731) to those without diabetes (n = 731) on baseline and clinical characteristics. Results Diabetic patients experienced smaller improvements in metabolic parameters after completing CR, including abdominal obesity, and lipid profiles (all P ≤ .002), compared to non-diabetic patients. For both groups, there were similar improvement rates in peak metabolic equivalents ([METs]; P  Conclusions Completing CR appears to provide comprehensive risk reduction in cardio-metabolic parameters associated with diabetes and MetS; however, CHD patients with diabetes may require additional and more aggressive attention towards all MetS criteria over the course of CR in order to prevent future cardiovascular events.
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References33
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#1Thomas R. Einarson (U of T: University of Toronto)H-Index: 54
#2Annabel AcsH-Index: 4
Last. Ulrik Haagen Panton (Novo Nordisk)H-Index: 3
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Cardiovascular disease (CVD) is a common comorbidity in type 2 diabetes (T2DM). CVD’s prevalence has been growing over time. To estimate the current prevalence of CVD among adults with T2DM by reviewing literature published within the last 10 years (2007–March 2017). We searched Medline, Embase, and proceedings of major scientific meetings for original research documenting the prevalence of CVD in T2DM. CVD included stroke, myocardial infarction, angina pectoris, heart failure, ischemic heart di...
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#1Deepika Laddu (UIC: University of Illinois at Chicago)H-Index: 7
#2Cemal Ozemek (UIC: University of Illinois at Chicago)H-Index: 10
Last. Billie-Jean Martin (Stanford University)H-Index: 16
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Abstract Background To determine and compare predictors of post-cardiac rehabilitation (CR) cardiorespiratory fitness (CRF) improvements in a large cohort of subjects with varying baseline CRF levels completing CR for ischemic heart disease, and to further refine prediction models by baseline CRF. Methods The Alberta Provincial Project for Outcomes Assessment in Coronary Heart Disease (APPROACH) and TotalCardiology TM databases were used retrospectively, to obtain information on 10,732 [1955 (18...
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#1N. H. Cho (International Diabetes Federation)H-Index: 40
#2Jonathan E. ShawH-Index: 96
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Abstract Introduction Since the year 2000, IDF has been measuring the prevalence of diabetes nationally, regionally and globally. Aim To produce estimates of the global burden of diabetes and its impact for 2017 and projections for 2045. Methods A systematic literature review was conducted to identify published studies on the prevalence of diabetes, impaired glucose tolerance and hyperglycaemia in pregnancy in the period from 1990 to 2016. The highest quality studies on diabetes prevalence were ...
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Cardiovascular rehabilitation (CR) is the process of developing and maintaining an optimal level of physical, social, and psychological well-being in order to promote recovery from cardiovascular (CV) illness. It is a multi-disciplinary approach encompassing supervised exercise training, patient counseling, education and nutritional guidance that may also enhance quality of life. Beneficial CV effects may include improving coronary heart disease risk factors; particularly exercise capacity, reve...
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If the control of infectious diseases was the public health success story of the first half of the 20th century, then the decline in mortality from coronary heart disease and stroke has been the success story of the century’s past 4 decades. The early phase of this decline in coronary heart disease and stroke was unexpected and controversial when first reported in the mid-1970s, having followed 60 years of gradual increase as the US population aged. However, in 1978, the participants in a confer...
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#1Robert RossH-Index: 51
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Mounting evidence has firmly established that low levels of cardiorespiratory fitness (CRF) are associated with a high risk of cardiovascular disease, all-cause mortality, and mortality rates attributable to various cancers. A growing body of epidemiological and clinical evidence demonstrates not only that CRF is a potentially stronger predictor of mortality than established risk factors such as smoking, hypertension, high cholesterol, and type 2 diabetes mellitus, but that the addition of CRF t...
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PURPOSE:The goal of this study was to determine the prevalence of insulin resistance (IR) and type 2 diabetes mellitus (T2DM) in contemporary cardiac rehabilitation (CR) and to compare clinical responses in CR between these subsets of patients with coronary heart disease (CHD). METHODS:The study cohort included 818 patients enrolled in CR and separated into 3 groups: (1) individuals with normal hemoglobin A1c (HbA1c) (NoIR: HbA1c < 5.7%); (2) individuals with IR (IR: HbA1c ≥ 5.7 to <6.5%); (3) a...
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#1Jillian D. Colbert (U of C: University of Calgary)H-Index: 3
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BackgroundCardiac rehabilitation (CR) reduces mortality in women and men with coronary artery disease (CAD). The objective of this study was to examine sex differences in long-term mortality, based on CR referral rates and attendance patterns in a large CAD population.DesignThis is a retrospective cohort study.MethodsThe Alberta Provincial Project for Outcomes Assessment in Coronary Heart Disease (APPROACH) and Cardiac Wellness Institute of Calgary (CWIC) databases were used to obtain informatio...
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Background Diabetic patients have a worse prognosis than nondiabetic patients after myocardial infarction. Although exercise improves risk factors, exercise capacity, and mortality, it is still unclear if these benefits are the same as in nondiabetics. Furthermore, although exercise tolerance is predicted by systolic and diastolic dysfunction in nondiabetics, its role as a predictor of exercise capacity in diabetics remains unclear. Hypothesis Diabetics and nondiabetics see a similar improvement...
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