TY  - JOUR
A1  - Salzwedel, Annett
A1  - Reibis, Rona Katharina
A1  - Wegscheider, Karl
A1  - Eichler, Sarah
A1  - Buhlert, Hermann
A1  - Kaminski, Stefan
A1  - Völler, Heinz
T1  - Cardiopulmonary exercise testing is predictive of return to work in cardiac patients after multicomponent rehabilitation
JF  - Clinical research in cardiology : official journal of the German Cardiac Society.
N2  - Return to work (RTW) is a pivotal goal of cardiac rehabilitation (CR) in patients after acute cardiac event. We aimed to evaluate cardiopulmonary exercise testing (CPX) parameters as predictors for RTW at discharge after CR. We analyzed data from a registry of 489 working-age patients (51.5 +/- A 6.9 years, 87.9 % men) who had undergone inpatient CR predominantly after percutaneous coronary intervention (PCI 62.6 %), coronary artery bypass graft (CABG 17.2 %), or heart valve replacement (9.0 %). Sociodemographic and clinical parameters, noninvasive cardiac diagnostic (2D echo, exercise ECG, 6MWT) and psychodiagnostic screening data, as well as CPX findings, were merged with RTW data from the German statutory pension insurance program and analyzed for prognostic ability. During a mean follow-up of 26.5 +/- A 11.9 months, 373 (76.3 %) patients returned to work, 116 (23.7 %) did not, and 60 (12.3 %) retired. After adjustment for covariates, elective CABG (HR 0.68, 95 % CI 0.47-0.98; p = 0.036) and work intensity (per level HR 0.83, 95 % CI 0.73-0.93; p = 0.002) were negatively associated with the probability of RTW. Exercise capacity in CPX (in Watts) and the VE/VCO2-slope had independent prognostic significance for RTW. A higher work load increased (HR 1.17, 95 % CI 1.02-1.35; p = 0.028) the probability of RTW, while a higher VE/VCO2 slope decreased (HR 0.85, 95 % CI 0.76-0.96; p = 0.009) it. CPX also had prognostic value for retirement: the likelihood of retirement decreased with increasing exercise capacity (HR 0.50, 95 % CI 0.30-0.82; p = 0.006).
KW  - Cardiac rehabilitation
KW  - Prognosis
KW  - Exercise capacity
KW  - Coronary disease
KW  - Social medicine
Y1  - 2016
U6  - https://doi.org/10.1007/s00392-015-0917-1
SN  - 1861-0684
SN  - 1861-0692
VL  - 105
SP  - 257
EP  - 267
PB  - Springer
CY  - Heidelberg
ER  -