{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T13:52:07Z","timestamp":1740145927097,"version":"3.37.3"},"reference-count":41,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2022,7,29]],"date-time":"2022-07-29T00:00:00Z","timestamp":1659052800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Cardiac Rehabilitation is an essential following major adverse cardiovascular events however there is no current data correlating rehab performance to long term outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Hypothesis<\/jats:title><jats:p>Patient exercise performance during cardiac rehabilitation reliably predicts future cardiovascular events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a single\u2010center study of 486 consecutive patients who participated in a CR program between January 2018 and August 2021. We assessed patient performance using a novel index, the CR\u2010score, which integrated duration, speed of work, and workload conducted on each training device (TD). We used a binary recursive partition model to determine the optimal thresholds for cumulative CR score. We used Cox regression analysis to assess the mortality rate among patients who developed MACE (\u201cstudy group\u201d) and those who did not (\"control group\u201d).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 486 eligible patients, 1\u2010year MACE occurred in 27 (5.5%) patients and was more common in patients with prior cerebrovascular accident or transient ischemic attack\u00a0(14.8% vs. 3.5%, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). Age, gender, comorbidities, heart failure, and medical treatment did not significantly affect the outcome. The median cumulative CR score of the study group was significantly lower than the control group (595\u2009\u00b1\u2009185.6 vs. 3500\u2009\u00b1\u20091104.7, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.0001). A cumulative CR\u2010score of \u22651132 correlated with the outcome (98.5% sensitivity, 99.6% specificity, 95% CI: 0.985\u22120.997, area 0.994, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.0001). Patients older than 55 with a cumulative CR score of &lt;1132 were at particularly high risk (OR: 7.4, 95% CI: 2.84\u221218.42) for 1\u2010year MACE (log\u2010rank <jats:italic>p<\/jats:italic>\u2009=\u2009.03).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our proposed CR\u2010score accurately identifies patients at high risk for 1\u2010year MACE following the rehabilitation program. Multicenter validation is required.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.23890","type":"journal-article","created":{"date-parts":[[2022,7,29]],"date-time":"2022-07-29T11:39:57Z","timestamp":1659094797000},"page":"1036-1043","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Cardiac rehabilitation performance predicts 1\u2010year major adverse cardiovascular events"],"prefix":"10.1002","volume":"45","author":[{"given":"Robert","family":"Naami","sequence":"first","affiliation":[{"name":"Internal Medicine, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edmund","family":"Naami","sequence":"additional","affiliation":[{"name":"School of Medicine University of Illinois  Springfield Illinois 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