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Functional Capacity Change after Phase II Cardiac Rehabilitation as a Predictor of Major Adverse Cardiac Event in Left Ventricular Dysfunction Patients Underwent Coronary Artery Bypass Grafting

Background: Phase II cardiac rehabilitation is essential for management post coronary artery bypass graft (CABG), especially in patients with left ventricular systolic dysfunction. Change in functional capacity after phase II cardiac rehabilitation (∆METs) is an indicator of cardiopulmonary and hemodynamic improvement after CABG. This study assessed the correlation of ∆METs as a predictor of major adverse cardiac event (MACE) 3 months after CABG in patients with left ventricular systolic dysfunction.
Methods: A cohort study was conducted on patients with left ventricular systolic dysfunction who underwent CABG between January 2019 to January 2021. Then patients were recruited to phase II cardiac rehabilitation, ∆METs was measured and tabulated by differences of functional capacity before and after the program. The abnormalities of ∆METs were discovered as a predictor of MACE determined by cut-off point, which is combination of death and rehospitalization. Patients were monitored for 3 months after CABG.
Result: Among 91 patients, 24.2% had MACE (6.6% death and 17.6% rehospitalization). We found significant correlation between ∆METs and MACE with cut-off point 3.25 METs (p <0.001). Multivariate analysis using logistic regression showed lower ∆METs group had significant correlation with MACE (OR 0.135; p 0.03). Kaplan Meier survival analysis showed lower ∆METs group was predictor of MACE on 3 months after CABG, risk of MACE occurrence 3.9 times than higher ∆METs group (p <0.001).
Conclusion: Change in functional capacity could predict MACE on 3 months follow-up of left ventricular systolic dysfunction patients who underwent CABG.

Keywords: Change in functional capacity; left ventricular systolic dysfunction; MACE; CABG.