Sex Differences in Frequency of Instrumental Activities of Daily Living after Cardiac Rehabilitation and Its Impact on Outcomes in Patients with Heart Failure
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Data Collection
2.3. IADL Measurement
2.4. Outcomes
2.5. Statistical Analyses
3. Results
3.1. Study Population
3.2. Differences in the Distribution of Total FAI Scores and Each of the Component Items between the Sexes
3.3. Cut-Off Values of FAI Score for All-Cause Mortality and Differences in Characteristics between the Groups
3.4. Association between FAI Score and Outcomes
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Missing Data | Overall (N = 490) | High FAI Score (N = 274) | Low FAI Score (N = 216) | p Value | |
---|---|---|---|---|---|
Age, years | 0 | 69 (58–76) | 67 (54–74) | 72 (63–78) | <0.001 |
Female, n (%) | 0 | 166 (33.9) | 110 (40.1) | 56 (25.9) | 0.001 |
BMI, kg/m2 | 0 | 21.9 (19.5–24.2) | 22.3 (19.7–25.3) | 21.4 (19.3–23.7) | 0.007 |
Etiology of HF, n (%) | 0 | ||||
Ischemic | 175 (35.7) | 94 (34.3) | 81 (37.5) | 0.102 | |
Hypertension | 122 (24.9) | 76 (27.8) | 46 (21.3) | ||
Valvular | 69 (14.1) | 41 (15.0) | 28 (13.0) | ||
Others | 124 (25.3) | 63 (23.0) | 61 (28.2) | ||
NYHA functional class, n (%) | 0 | <0.001 | |||
Ⅰ/Ⅱ | 345 (490) | 225 (82.1) | 120 (55.6) | ||
Ⅲ/Ⅳ | 145 (29.6) | 49 (17.9) | 96 (44.4) | ||
LVEF, % | 27 | 48 (33–59) | 50 (35–61) | 47 (31–58) | 0.129 |
LVEF <40, n (%) | 173 (35.3) | 90 (32.8) | 83 (38.4) | 0.293 | |
LVEF ≥50, n (%) | 223 (45.5) | 129 (47.1) | 94 (43.5) | 0.366 | |
Comorbidities, n (%) | |||||
Hypertension | 0 | 308 (62.9) | 159 (58.0) | 149 (69.0) | 0.013 |
Diabetes mellitus | 0 | 171 (34.9) | 78 (28.5) | 93 (43.0) | 0.001 |
Dyslipidemia | 0 | 240 (49.0) | 128 (46.7) | 112 (51.9) | 0.259 |
Atrial fibrillation | 0 | 68 (13.9) | 38 (13.9) | 30 (13.9) | 0.992 |
Ischemic etiology | 0 | 203 (41.4) | 100 (36.5) | 103 (47.7) | 0.013 |
Prior HF admission, n (%) | 0 | 243 (50.0) | 126 (46.0) | 117 (54.2) | 0.072 |
Current smoker, n (%) | 0 | 87 (17.8) | 45 (16.4) | 42 (19.4) | 0.336 |
Laboratory data | |||||
Hemoglobin, g/dL | 1 | 12.3 (10.8–14.0) | 12.6 (11.1–14.0) | 12.1 (10.4–14.1) | 0.068 |
Albumin, g/dL | 1 | 3.8 (3.4–4.0) | 3.8 (3.4–4.1) | 3.7 (3.4–4.0) | 0.036 |
Creatinine, mg/dL | 1 | 0.98 (0.80–1.34) | 0.92 (0.77–1.24) | 1.07 (0.86–1.55) | <0.001 |
eGFR, mL/min/1.73 m2 | 1 | 54.6 (37.7–69.6) | 57.7 (43.3–72.6) | 50.3 (28.1–65.6) | <0.001 |
Sodium, mEq/mL | 1 | 139 (136–140) | 139 (136–141) | 138 (136–140) | 0.184 |
BNP, pg/mL | 34 | 219 (104–463) | 191 (94–369) | 278 (126–684) | <0.001 |
Medications, n (%) | |||||
ACEI/ARB | 0 | 418 (85.3) | 237 (86.5) | 181 (66.1) | 0.402 |
β blocker | 0 | 376 (76.7) | 218 (79.6) | 158 (73.1) | 0.095 |
MRA | 0 | 220 (44.9) | 118 (43.1) | 102 (47.2) | 0.358 |
Diuretics | 0 | 409 (83.5) | 224 (81.8) | 185 (85.6) | 0.100 |
AHEAD score | 0 | 2 (1–3) | 1 (1–2) | 2 (1–3) | <0.001 |
FAI | 0 | 24 (16–29) | 29 (26–32) | 15 (10–19) | <0.001 |
Outcomes | No. of Events/Cases | Event Rate per 100 Persons-Years | HR (95% CI) | p Value |
---|---|---|---|---|
All-cause mortality (Per 1 point increase) | 95/490 (19.4%) | 4.2 | 0.961 (0.937–0.986) | 0.002 |
High FAI score | 28/274 (10.2%) | 1.0 | 1 (Reference) | |
Low FAI score | 67/216 (31.0%) | 6.5 | 2.69 (1.64–4.44) | <0.001 |
Combined events (Per 1 point increase) | 213/490 (43.5%) | 9.1 | 0.968 (0.952–0.985) | <0.001 |
High FAI score | 89/274 (32.5%) | 6.8 | 1 (Reference) | |
Low FAI score | 114/216 (52.8%) | 11.0 | 1.552 (1.054–2.353) | 0.033 |
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Nozaki, K.; Hamazaki, N.; Kamiya, K.; Kariya, H.; Uchida, S.; Noda, T.; Ueno, K.; Maekawa, E.; Matsunaga, A.; Yamaoka-Tojo, M.; et al. Sex Differences in Frequency of Instrumental Activities of Daily Living after Cardiac Rehabilitation and Its Impact on Outcomes in Patients with Heart Failure. J. Cardiovasc. Dev. Dis. 2022, 9, 289. https://0-doi-org.brum.beds.ac.uk/10.3390/jcdd9090289
Nozaki K, Hamazaki N, Kamiya K, Kariya H, Uchida S, Noda T, Ueno K, Maekawa E, Matsunaga A, Yamaoka-Tojo M, et al. Sex Differences in Frequency of Instrumental Activities of Daily Living after Cardiac Rehabilitation and Its Impact on Outcomes in Patients with Heart Failure. Journal of Cardiovascular Development and Disease. 2022; 9(9):289. https://0-doi-org.brum.beds.ac.uk/10.3390/jcdd9090289
Chicago/Turabian StyleNozaki, Kohei, Nobuaki Hamazaki, Kentaro Kamiya, Hidenori Kariya, Shota Uchida, Takumi Noda, Kensuke Ueno, Emi Maekawa, Atsuhiko Matsunaga, Minako Yamaoka-Tojo, and et al. 2022. "Sex Differences in Frequency of Instrumental Activities of Daily Living after Cardiac Rehabilitation and Its Impact on Outcomes in Patients with Heart Failure" Journal of Cardiovascular Development and Disease 9, no. 9: 289. https://0-doi-org.brum.beds.ac.uk/10.3390/jcdd9090289