Factor Associated with Improvement of VO2 Max after Cardiac Rehabilitation in Patients with Coronary Artery Disease Post Revascularization

Abstract

Aims: This study aimed to assess the association of cardiovascular risk factors and the number of risk factors with improvement of VO2 Max in patients with coronary artery disease (CAD) post-revascularization by Coronary Artery Bypass Graft (CABG) and Percutaneous Coronary Intervention (PCI) after completing phase II cardiac rehabilitation (CR).

Methods: This was an analytic study with a cross-sectional design. Data were taken retrospectively using secondary data from medical records. The study population was post-revascularization CAD patients who underwent phase II CR at RSUP Dr. Hasan Sadikin Bandung in 2019-2020, and samples were taken by total sampling method. Data were processed with Microsoft Excel 2016 and Statistical Software R version 4.0.0, then presented analytically. The characteristics were described based on age, sex, body mass index, education, occupation, and the number of risk factors. Characteristic data were grouped based on the CABG and PCI interventions obtained. Correlation analysis was conducted to assess the association of age, family history, physical inactivity, smoking, obesity, hypertension, dyslipidemia, and diabetes mellitus risk factors and the number of risk factors with VO2 Max. Data were analyzed with appropriate statistical tests.

Results: The median (range) of improvement of VO2 Max was 6.00 (1.20, 17.73) (ml/kg/min). Smoking was significantly associated with an improvement of VO2 Max (p-value 0.0197), while age, family history, physical inactivity, obesity, hypertension, dyslipidemia, and diabetes mellitus were not. Patients with a total of seven risk factors had the highest improvement of VO2 Max with 12.88 (3.15, 12.90) (ml/kg/minute), followed by patients with a total of six risk factors with 9.84 (1.80, 16.44) (ml/kg/minute). However, the number of risk factors had no significant association with the improvement of VO2 Max.

Conclusion: Smoking as a CVD risk factor was associated with improvement of VO2 Max, while age, family history, physical inactivity, obesity, hypertension, dyslipidemia, and diabetes mellitus were not. The number of risk factors had no significant association with the improvement of VO2 Max.