@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} }