Rationale and Objective:
Comorbid conditions in patients with coronary artery disease (CAD) affect clinical outcomes. Assessment of comorbidities is important for risk stratification and outcome evaluation. Weighted Comorbidity Indexes (CMIs) have been developed to help quantify the burden of comorbid conditions, including one in a CR population (CMI-CR) and another among patients undergoing cardiac catheterization (CMI-CAD). We compared the characteristics of the two CMIs within our CR population.
Methodology:
Data from patients enrolled in our CR program between 1/96-12/04 were examined to compare the two CMI scoring protocols and resulting patient classification.
Results:
Patients with CAD (n = 901) included 33% women, 33% non-white, average age was 60 (+/-11) years. AACVPR risk stratification included 44% high, 36% intermediate, and 20% low risk. Risk factors were prevalent: 85% dyslipidemia, 77% hypertension, 36% diabetes 50% obese, 69% with low physical activity and 20% smoking. Mean CMI-CR was 1.6 (+/-1.6) with a range of 0-8. Mean CMI-CAD was 2.8 (+/-2.2) with a range of 0-14. The CMI's were significantly correlated (0.84; P <.01) but the distribution of patients within the score rankings varied between the CMIs, primarily due to different weighting of renal disease. The table illustrates the range of CMI-CAD scores that classified patients within each CMI-CR score.
Conclusion:
Although the CAD-specific CMIs were significantly correlated in this CR population, different patient groups were identified as having high co-morbidity burden in large part related to the differential weighting of renal disease. Future studies need to evaluate and compare the prognostic utility of the two indexes for short-term (during CR) and long-term (after CR) outcomes in CR populations.