37605
2014
2014
eng
1125
1133
9
9
21
article
Sage Publ.
London
1
--
--
--
Treatment patterns, risk factor control and functional capacity in patients with cardiovascular and chronic kidney disease in the cardiac rehabilitation setting
Background: Chronic kidney disease (CKD) is a frequent comorbidity among elderly patients and those with cardiovascular disease. CKD carries prognostic relevance. We aimed to describe patient characteristics, risk factor management and control status of patients in cardiac rehabilitation (CR), differentiated by presence or absence of CKD.
Design and methods: Data from 92,071 inpatients with adequate information to calculate glomerular filtration rate (GFR) based on the Cockcroft-Gault formula were analyzed at the beginning and the end of a 3-week CR stay. CKD was defined as estimated GFR <60 ml/min/1.73 m(2).
Results: Compared with non-CKD patients, CKD patients were significantly older (72.0 versus 58.0 years) and more often had diabetes mellitus, arterial hypertension, and atherothrombotic manifestations (previous stroke, peripheral arterial disease), but fewer were current or previous smokers had a CHD family history. Exercise capacity was much lower in CKD (59 vs. 92Watts). Fewer patients with CKD were treated with percutaneous coronary intervention (PCI), but more had coronary artery bypass graft (CABG) surgery. Patients with CKD compared with non-CKD less frequently received statins, acetylsalicylic acid (ASA), clopidogrel, beta blockers, and angiotensin converting enzyme (ACE) inhibitors, and more frequently received angiotensin receptor blockers, insulin and oral anticoagulants. In CKD, mean low density lipoprotein cholesterol (LDL-C), total cholesterol, and high density lipoprotein cholesterol (HDL-C) were slightly higher at baseline, while triglycerides were substantially lower. This lipid pattern did not change at the discharge visit, but overall control rates for all described parameters (with the exception of HDL-C) were improved substantially. At discharge, systolic blood pressure (BP) was higher in CKD (124 versus 121 mmHg) and diastolic BP was lower (72 versus 74 mmHg). At discharge, 68.7% of CKD versus 71.9% of non-CKD patients had LDL-C <100 mg/dl. Physical fitness on exercise testing improved substantially in both groups. When the Modification of Diet in Renal Disease (MDRD) formula was used for CKD classification, there was no clinically relevant change in these results.
Conclusion: Within a short period of 3-4 weeks, CR led to substantial improvements in key risk factors such as lipid profile, blood pressure, and physical fitness for all patients, even if CKD was present.
European journal of preventive cardiology : the official ESC journal for primary & secondary cardiovascular prevention, rehabilitation and sports cardiology
10.1177/2047487313482285
23508927
2047-4873
2047-4881
wos:2014
WOS:000340729300008
Voller, H (reprint author), Univ Potsdam, Neuen Palais 10,Haus 12, D-14469 Potsdam, Germany., heinz.voeller@uni-potsdam.de
MSD Sharp & Dohme GmbH, Munich-Haar, Germany; MSD
<a href="http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-40406">Zweitveröffentlichung in der Schriftenreihe Postprints der Universität Potsdam : Humanwissenschaftliche Reihe ; 381</a>
Heinz Völler
Anselm Gitt
Christina Jannowitz
Marthin Karoff
Barbara Karmann
David Pittrow
Rona Katharina Reibis
Steven Hildemann
eng
uncontrolled
Cardiac rehabilitation
eng
uncontrolled
registry
eng
uncontrolled
chronic kidney disease
eng
uncontrolled
glomerular filtration rate
eng
uncontrolled
dyslipidemia
eng
uncontrolled
control rates
eng
uncontrolled
risk factor
eng
uncontrolled
lipids
Strukturbereich Kognitionswissenschaften
Referiert
Exzellenzbereich Kognitionswissenschaften
40406
2014
2018
eng
9
381
postprint
1
2018-03-27
2018-03-27
--
Treatment patterns, risk factor control and functional capacity in patients with cardiovascular and chronic kidney disease in the cardiac rehabilitation setting
Background: Chronic kidney disease (CKD) is a frequent comorbidity among elderly patients and those with cardiovascular disease. CKD carries prognostic relevance. We aimed to describe patient characteristics, risk factor management and control status of patients in cardiac rehabilitation (CR), differentiated by presence or absence of CKD.
Design and methods: Data from 92,071 inpatients with adequate information to calculate glomerular filtration rate (GFR) based on the Cockcroft-Gault formula were analyzed at the beginning and the end of a 3-week CR stay. CKD was defined as estimated GFR <60 ml/min/1.73 m(2).
Results: Compared with non-CKD patients, CKD patients were significantly older (72.0 versus 58.0 years) and more often had diabetes mellitus, arterial hypertension, and atherothrombotic manifestations (previous stroke, peripheral arterial disease), but fewer were current or previous smokers had a CHD family history. Exercise capacity was much lower in CKD (59 vs. 92Watts). Fewer patients with CKD were treated with percutaneous coronary intervention (PCI), but more had coronary artery bypass graft (CABG) surgery. Patients with CKD compared with non-CKD less frequently received statins, acetylsalicylic acid (ASA), clopidogrel, beta blockers, and angiotensin converting enzyme (ACE) inhibitors, and more frequently received angiotensin receptor blockers, insulin and oral anticoagulants. In CKD, mean low density lipoprotein cholesterol (LDL-C), total cholesterol, and high density lipoprotein cholesterol (HDL-C) were slightly higher at baseline, while triglycerides were substantially lower. This lipid pattern did not change at the discharge visit, but overall control rates for all described parameters (with the exception of HDL-C) were improved substantially. At discharge, systolic blood pressure (BP) was higher in CKD (124 versus 121 mmHg) and diastolic BP was lower (72 versus 74 mmHg). At discharge, 68.7% of CKD versus 71.9% of non-CKD patients had LDL-C <100 mg/dl. Physical fitness on exercise testing improved substantially in both groups. When the Modification of Diet in Renal Disease (MDRD) formula was used for CKD classification, there was no clinically relevant change in these results.
Conclusion: Within a short period of 3-4 weeks, CR led to substantial improvements in key risk factors such as lipid profile, blood pressure, and physical fitness for all patients, even if CKD was present.
Postprints der Universität Potsdam : Humanwissenschaftliche Reihe
urn:nbn:de:kobv:517-opus4-404065
online registration
European Journal of Preventive Cardiology (2014), Nr. 21(9), S.1125-1133 DOI 10.1177/2047487313482285
<a href="http://publishup.uni-potsdam.de/opus4-ubp/frontdoor/index/index/docId/37605">Bibliographieeintrag der Originalveröffentlichung/Quelle</a>
Keine öffentliche Lizenz: Unter Urheberrechtsschutz
Heinz Völler
Anselm Gitt
Christina Jannowitz
Marthin Karoff
Barbara Karmann
David Pittrow
Rona Katharina Reibis
Steven Hildemann
Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe
381
eng
uncontrolled
Cardiac rehabilitation
eng
uncontrolled
registry
eng
uncontrolled
chronic kidney disease
eng
uncontrolled
glomerular filtration rate
eng
uncontrolled
dyslipidemia
eng
uncontrolled
control rates
eng
uncontrolled
risk factor
eng
uncontrolled
lipids
Technik, Medizin, angewandte Wissenschaften
Medizin und Gesundheit
Medizin und Gesundheit
open_access
Humanwissenschaftliche Fakultät
Referiert
Open Access
Sage
Universität Potsdam
https://publishup.uni-potsdam.de/files/40406/phr381.online.pdf