@article{ReibisVoellerGittetal.2014, author = {Reibis, Rona Katharina and V{\"o}ller, Heinz and Gitt, Anselm and Jannowitz, Christina and Halle, Martin and Pittrow, David and Hildemann, Steven}, title = {Management of patients with ST- segment elevation or non- ST- segment elevation acute coronary syndromes in cardiac rehabilitation centers}, series = {Clinical cardiology : international journal for cardiovascular diseases}, volume = {37}, journal = {Clinical cardiology : international journal for cardiovascular diseases}, number = {4}, publisher = {Wiley-Blackwell}, address = {Hoboken}, issn = {0160-9289}, doi = {10.1002/clc.22241}, pages = {213 -- 221}, year = {2014}, abstract = {BackgroundCurrent 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.}, language = {en} } @article{ReibisJannowitzHalleetal.2015, author = {Reibis, Rona Katharina and Jannowitz, Christina and Halle, Martin and Pittrow, David and Gitt, Anselm and V{\"o}ller, Heinz}, title = {Management and outcomes of patients with reduced ejection fraction after acute myocardial infarction in cardiac rehabilitation centers}, series = {Current medical research and opinion}, volume = {31}, journal = {Current medical research and opinion}, number = {2}, publisher = {Taylor \& Francis Group}, address = {London}, issn = {0300-7995}, doi = {10.1185/03007995.2014.977854}, pages = {211 -- 219}, year = {2015}, abstract = {Background: We aimed to describe the contemporary management of patients with systolic chronic heart failure (CHF) during a cardiac rehabilitation (CR) stay and present outcomes with focus on lipids, blood pressure, exercise capacity, and clinical events. Methods: Comparison of 3199 patients with moderately or severely impaired left ventricular ejection fraction (low EF, 13.3\%) and 20,913 patients with slightly reduced or normal LVEF (normal EF, 86.7\%) who underwent an inpatient CR period of about 3 weeks in 2009-2010. Results: Patients with low EF compared to those with normal EF were somewhat older (65.1 vs. 63.0 years, p<0.0001), and more often had risk factors such as diabetes mellitus (39.7\% vs. 32.0\%, p<0.0001) or other comorbidities. The overall rate of patients with regular physical activity of at least 90 minutes per week prior to CR was low overall (54.4\%), and reduced in patients with low EF compared to those with normal EF (47.7\% vs. 55.5\%, p<0.0001). The rate of patients that achieved lower LDL cholesterol (5100 mg/dl), total cholesterol (<200 mg/dl) and triglyceride (<150 mg/dl) values at discharge increased compared to baseline. Mean blood pressure was substantially lower in the low EF group compared to the normal EF group both at baseline (124/75 vs. 130/78 mmHg, p<0.0001) and at discharge (119/72 vs. 124/74 mmHg, p<0.0001). Maximum exercise improved substantially in both groups (at baseline 71 vs. 91 Watts, p<0.0001; at discharge 85 vs. 105 Watts, p<0.0001). Event rates during CR were low, and only 0.3\% in the low EF group died. As limitations to this study, information on brain natriuretic peptide (BNP), N-terminal pro-brain natriuretic peptide (NT-pro BNP) and/or cardiac troponin were not documented, and no long-term information was collected beyond the 3-week CR stay. Conclusions: Patients with CHF account for a considerable proportion of patients in CR. Also patients with moderate/severe EF benefited from participation in CR, as their lipid profile and physical fitness improved.}, language = {en} }