Abstract
Purpose: Cardiac rehabilitation (CR) yields improvements in cardiorespiratory fitness (peak oxygen uptake [V[spacing dot above]O2peak]). Predictors of change in V[spacing dot above]O2peak have been reported among patients with coronary artery disease (CAD) but have not been compared with peripheral artery disease (PAD). This study determined predictors of improved V[spacing dot above]O2peak among patients with PAD, CAD, and concomitant PAD and CAD (PAD/CAD) following a 6-mo home-based outpatient CR program (1supervised and 4 home weekly sessions).
Methods: This study was a retrospective (2006-2017) multiple linear regression analysis of CR patients with PAD (n = 63), CAD (n = 63), and PAD/CAD (n = 164). Peripheral artery disease and CAD were matched for age, sex, smoking status, diabetes, and year in program.
Results: Mean age of all patients was 68.9+/-10.1 yr, 72% were male, and mean improvement in V[spacing dot above]O2peak was 2.1 +/- 3.3 mL/kg/min (14.5% improvement) following CR. In CAD, younger age ([beta] = .30, P = .015), male sex ([beta] = -.29, P = .019), and more recent year of entry ([beta] = .26, P = .035) were predictors of improved V[spacing dot above]O2peak. In PAD, only male sex ([beta] = -.36, P = .004) and in PAD/CAD, not having diabetes ([beta] = -.24, P = .002), not smoking ([beta] = -.25, P = .001), and shorter elapsed time from referring diagnosis to entry ([beta] = -.19, P = .016) were predictors.
Conclusions: While younger age and male sex were predictors of improved V[spacing dot above]O2peak in CAD, age did not influence PAD, and neither age nor sex influenced PAD/CAD. Peripheral artery disease-related limitations may override some demographic factors, and strategies for improving V[spacing dot above]O2peak should be explored. Managing smoking and comorbid diagnoses including diabetes and a timely entry to CR may yield greater improvements in V[spacing dot above]O2peak among individuals with PAD.