Gender difference in long-term effect of cardiac rehabilitation; data from CRAGE-extra study

Introduction: The positive effect of cardiac rehabilitation (CR) is demonstrated in younger and older patients. However, it is quite debated whether the beneficial effect is similarly maintained in both genders during follow-up.

Aim: to determine if the improvement obtained after CR remained significant at 1-year follow-up in older population, testing the influence of gender on this outcome.

Methods: All patients aged 75+ years consecutively referred to Cardiac Rehabilitation outpatient Unit at Careggi University Hospital were screened for eligibility. All patients attended a CR program, based on 5-day-per-week aerobic training sessions for 4 weeks and they were evaluated at the end of CR at 6 and 12 months of follow-up.

Results: 361 patients with a mean age 80.6 ± 4.4 years with a complete 1-year follow-up were enrolled in the study, 87.5 % of them had an acute coronary event, and 27.6 % were females. The increase in exercise capacity at the end of CR and at 1-year follow-up was statistically significant (VO2 peak: +8.7 % in males p < 0.001, +8.5 % in females p < 0.001; distance walked at 6-min test: +7.3 % in males p < 0.001, +10.2 % in females p < 0.001, respectively); the trajectory of exercise improvement at 6 and 12 months of FU was similar in men and women without significant decrease (VO2 peak-ml/kg/min: CR discharge vs 1 year FU = 15.2 vs 15,0 p: NS; distance walked-meters: CR discharge vs 1 year FU = 445.5 vs 440.6, p: NS) from end of CR to 1-year.

Conclusions: the improvement in exercise tolerance obtained with CR program is still maintained at 1-year FU without significant influence of gender in our very old population.