A Retrospective Comparison of Fitness and Exercise Progression in Patients With Coronary and Peripheral Artery Disease in Cardiac Rehabilitation

Background: Cardiac rehabilitation (CR) is recommended for patients with coronary (CAD) and peripheral (PAD) artery disease. However, no study has compared changes in cardiorespiratory fitness (VO2peak) or exercise prescription progression among PAD, CAD, and concomitant PAD and CAD (BOTH). The objectives of this study were to 1) compare change in VO2peak among patients with PAD, CAD, and BOTH, and 2) examine progression in exercise prescription parameters in a comprehensive 6-month cardiac rehabilitation (CR) program. Methods: A retrospective analysis of patient data recorded from 2006 to 2017 from a large urban hospital was conducted. Patients with PAD (n = 63) and BOTH (n = 164) were included in the analyses. Patients with CAD (n = 63) were matched to PAD by sex (36.5% female), age (69 years), smoking status, diabetes, and year in program. Results: There were significant improvements in VO2peak from baseline to 6 months in all groups (CAD thorn2.7 +/- 3.4 mL,kg(-1),min(-1), PAD thorn2.4 +/- 3.8 mL,kg(-1),min(-1), BOTH thorn1.8 +/- 3.1 mL,kg(-1),min(-1); all P < 0.001). Between-group differences were significant between PAD and CAD as well as between CAD and BOTH (P = 0.001). Walking distance, duration, and pace increased for all groups over 6 months (P < 0.001), with a significant difference in pace between CAD and BOTH (P = 0.006). Conclusions: Patients with PAD, CAD, and BOTH had significant improvements in VO2peak following a 6-month CR program. However, despite similar prescribed walking distance and duration, improvements in VO2peak were mitigated in PAD and BOTH compared with CAD. These results support benefits of CR for patients diagnosed with PAD, but alternate exercise strategies should be explored for patients with PAD.

Automated summary

The study demonstrated significant improvements in VO2peak for patients with PAD, CAD, and BOTH following a 6-month CR program. Despite similar prescribed walking distance and duration, improvements in VO2peak were less pronounced in patients with PAD and BOTH compared to those with CAD. Further exploration of alternate exercise strategies for PAD patients is recommended.