Management of Patients With ST-Segment Elevation or Non–ST-Segment Elevation Acute Coronary Syndromes in Cardiac Rehabilitation Centers

摘要

ABSTRACTBackgroundCurrent data on the management of patients in cardiac rehabilitation (CR) after an acute hospital stay due to ST-segment elevation or non–ST segment elevation acute coronary syndromes (STE-ACS or NSTE-ACS) are limited. We aimed to describe patient characteristics, risk factor management, and lipid target achievement of patients in CR in Germany and compare the 2 groups.HypothesisWith respect to the risk factor pattern and treatment effects during a CR stay, there are important differences between STE-ACS and NSTE-ACS patients.MethodsComparison of 7950 patients by STE-ACS or NSTE-ACS status in the Transparency Registry to Objectify Guideline-Oriented Risk Factor Management registry (2010) who underwent an inpatient CR period of about 3 weeks.ResultsSTE-ACS patients compared to NSTE-ACS patients were significantly younger (60.5 vs 64.4 years, P 0.0001), and had diabetes mellitus, hypertension, or any risk factor (exception: smoking) less often. At discharge, in STE-ACS compared to NSTE-ACS patients, the low-density lipoprotein cholesterol (LDL-C) 100 mg/dL goal was achieved by 75.3% and 76.2%, respectively (LDL-C 70 mg/dL by 27.7% and 27.4%), the high-density lipoprotein cholesterol goal of 50 mg/dL in women and 40 mg/dL in men was achieved by 49.3% and 49.0%, respectively, and the triglycerides goal of 150 mg/dl was achievedby 72.3% and 74.3%, respectively (all comparisons not significant). Mean systolic and diastolic blood pressure were 121/74 and 123/74 mm Hg, respectively (P 0.0001 systolic, diastolic not significant). The maximum exercise capacity was 110 and 102 W, respectively (P 0.0001), and the maximum walking distance was 581 and 451 meters, respectively (P value not significant).ConclusionsPatients with STE-ACS and NSTE-ACS differed moderately in their baseline characteristics. Both groups benefited from the participation in CR, as their lipid profile, blood pressure, and physical fitness improved.