[The role of ambulatory cardiac rehabilitation on return to work of patients with cardiovascular diseases].

Cardiovascular diseases are the leading cause of morbidity and mortality in developed countries and about 50% of myocardial infarctions occur in working age individuals. Return to work rates are determined by cardiovascular parameters as well as by psychosocial factors and a Cardiac Rehabilitation program after an acute coronary syndrome or coronary revascularization has shown to improve the cardiovascular outcome, occupational recovery and professional reintegration through a multidisciplinary intervention including physical exercise, lipid and blood pressure control, smoking cessation program, nutritional advice, psychological counselling and target-driven pharmacological therapies. The collaboration between cardiologist and occupational physician is crucial in the transition from illness to an active social position defining the work eligibility with the assessment of cardiological profile, comorbidities, psychological functions, worker's ability and functional capacity.

Prognostic Role of Left Ventricular Dysfunction in Patients With Coronary Artery Disease After an Ambulatory Cardiac Rehabilitation Program.

The relationship between left ventricular ejection fraction (LVEF) and outcomes after cardiac rehabilitation (CR) is not well established; therefore we assessed the prognostic role of LVEF at the end of ambulatory CR program in patients (pts) who received coronary revascularization. LVEF was evaluated at hospital discharge and re-assessed at the end of CR in all ST-elevation myocardial infarction and coronary artery bypass graft pts, while in pts with non-ST-elevation MI or elective percutaneous coronary intervention the echocardiography was repeated if they had an impaired LVEF at discharge. New hospitalizations for cardiovascular causes at 1-year, and cardiovascular mortality during long-term follow-up were analyzed.

Impact of ambulatory cardiac rehabilitation on cardiovascular outcomes: a long-term follow-up study.

Aims: To evaluate the long-term clinical impact of the application of cardiac rehabilitation (CR) early after discharge in a real-world population.

Methods And Results: We analysed the 5-year incidence of cardiovascular mortality and hospitalization for cardiovascular causes in two populations, attenders vs. non-attenders to an ambulatory CR program which were consecutively discharged from two tertiary hospitals, after ST-elevation myocardial infarction, non-ST-elevation myocardial infarction, coronary artery bypass graft, or planned percutaneous coronary intervention.

Early occurrence of drug intolerance as risk factor during follow-up in patients with acute coronary syndrome or coronary revascularization.

Aims: The occurrence of drug intolerance (DI) after an acute coronary syndrome (ACS) or percutaneous coronary intervention (PCI) is an important reason for quitting treatment. Nevertheless, the association between DI and major cardiac and cerebrovascular events (MACCE) is poorly reported in the literature, therefore, we analysed potential relationship between DI and MACCE (a composite of ACS, PCI, heart failure, and stroke) during follow-up.

Methods And Results: From 1 January 2014 to 31 December 2015, 891 consecutive patients after ACS or coronary revascularization were referred to cardiac rehabilitation (CR) programme and included in a dedicated registry where DI was analysed and treatment appropriately tailored.

[Ambulatory cardiac rehabilitation in Trieste: protocols of intervention, activities and outcomes].

Background: Cardiac rehabilitation (CR) is a model of care proven to reduce mortality and morbidity in patients with coronary artery disease. The aim of this study is to describe the ambulatory CR model of the Cardiovascular Department of Trieste (Italy), analyzing the outcome of the population.

Methods: We analyzed clinical and instrumental characteristics of all consecutive patients after ST-elevation myocardial infarction (STEMI), non-ST-elevation myocardial infarction (NSTEMI), coronary artery bypass graft with or without valve surgery (CABG/CABGV), or planned percutaneous coronary intervention (PCI), referred for CR from January 1, 2009, to December 31, 2015.

Current management and treatment of patients with stable coronary artery diseases presenting to cardiologists in different clinical contexts: A prospective, observational, nationwide study.

Background Stable coronary artery disease (CAD) is a leading cause of mortality worldwide. Few studies document the complete sequence of investigation of the overall stable CAD population during outpatient visits or hospitalisation. Aim To obtain accurate and up-to-date information on current management of patients with stable CAD.

'PERFSCORE' - a multidimensional score: a simple way to predict the success of cardiac rehabilitation.

Background: We propose a simple and reliable score, performance score ('PERFSCORE'), that allows cardiologists to assess the achievement of therapeutic goals.

Methods: We identified six indicators of cardiac rehabilitation performance: heart rate (HR) less than 70 beats/min; blood pressure (BP) less than 140/90 mmHg; smoking cessation or non-smokers; left ventricular ejection fraction (LVEF) more than 40%; LDLc less than 100 mg/dl or more than 70 mg/dl if diabetic; and on treatment at least with three drugs among angiotensin converting enzyme (ACE) inhibitors or angiotensin receptor blocker (ARBs), β-blockers, statins, and ASA. These six indicators are considered to be the collective expression of a latent variable measuring performance.

In-hospital and one-year outcomes of patients with high-risk acute myocardial infarction treated with thrombolysis or primary coronary angioplasty.

Background: The aim of this study was to observe the outcomes of high-risk patients with acute myocardial infarction treated with primary angioplasty and intravenous thrombolysis in a community setting.

Methods: A prospective study of the in-hospital and 12-month outcomes was conducted in 17 cardiology centers where primary angioplasty was available, and in 30 where it was not. Three thousand seventy-four patients in the first 12 hours of an evolving infarction were recruited; among these, 2227 patients who met one or more pre-defined criteria of increased risk were included in the study.