Cancer and cardiovascular disease: The impact of cardiac rehabilitation and cardiorespiratory fitness on survival
Cancer survivors are at increased risk for cardiovascular disease (CVD)-related morbidity and mortality. Exercise-based cardiac rehabilitation (CR) programs improve CVD risk factors, including cardiorespiratory fitness (CRF). The purpose of this study was to investigate: (1) the association between...
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| Vydané v: | International journal of cardiology Ročník 343; s. 139 - 145 |
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| Hlavní autori: | , , , , , , , |
| Médium: | Journal Article |
| Jazyk: | English |
| Vydavateľské údaje: |
Elsevier B.V
15.11.2021
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| Predmet: | |
| ISSN: | 0167-5273, 1874-1754, 1874-1754 |
| On-line prístup: | Získať plný text |
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| Shrnutí: | Cancer survivors are at increased risk for cardiovascular disease (CVD)-related morbidity and mortality. Exercise-based cardiac rehabilitation (CR) programs improve CVD risk factors, including cardiorespiratory fitness (CRF). The purpose of this study was to investigate: (1) the association between CR completion and survival, and (2) whether CRF improvements translate to increased survival among patients with comorbid cancer and CVD.
Patients with CVD and pre-existing cancer (any type) were referred to a 12-week exercise-based CR program between 01/1996 and 03/2016. Peak metabolic equivalents (METs) were assessed by graded exercise test pre-CR and at 12-weeks. Kaplan-Meier survival and multivariate cox regressions were performed to evaluate impact of CR completion and clinically-meaningful CRF improvements [ΔMETs≥1] on survival, adjusting for relevant covariates.
Among 442 patients with CVD and cancer referred to CR (67 ± 10 years; 22% women), 361 (82%) completed CR. 102 deaths were recorded during the 12-year observation period. Compared to patients who did not complete CR, patients with comorbid cancer who completed CR demonstrated a survival advantage (63% vs 80.1%, p < .001). CRF improved among completers during the 12-week program (mean change = 0.87 ± 0.93 METs, p < .001); 41% experienced a clinically-meaningful ΔMETs≥1. A survival advantage was not observed in completers who experienced a ΔMETs≥1 improvement (p = .254).
Completing a 12-week exercise-based CR program improved CRF and increased survival in patients with CVD and comorbid cancer. The results highlight the survival benefits of completing a CR program among CVD patients who experience added barriers imposed by cancer treatment and survival.
•Cancer predisposes individuals to cardiovascular disease (CVD)-related illness and death.•Exercise-based cardiac rehabilitation improved cardiorespiratory fitness in patients with CVD and cancer.•Cardiac rehabilitation completion improved survival in patients with CVD and cancer. |
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| Bibliografia: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 TW co-conceptualized the study, performed the data analyses, co-wrote the manuscript, and revised the manuscript. CM assisted with analyses, co-wrote the manuscript, and revised the manuscript. DC co-conceptualized the study, assisted with the data analyses, and critically revised the manuscript. CO provided consultation regarding the statistical approach and critically revised the manuscript. RA co-conceptualized the study and critically revised the manuscript. SA facilitated the data merge and critically revised the manuscript. TC supervised the student collaborators (TW and CM) and critically revised the manuscript. DL conceptualized the research question, co-conceptualized the study and statistical approach, and critically revised the manuscript. Authors’ contributions |
| ISSN: | 0167-5273 1874-1754 1874-1754 |
| DOI: | 10.1016/j.ijcard.2021.09.004 |