BACKGROUND Few studies have evaluated the therapeutic effect of long-term cardiac rehabilitation (CR) and no large-scale survey of cardiovascular outcomes after long-term CR is reported. METHODS This cohort study included 9981 patients undergoing CR from 2004 to 2015. Patients who had supervised CR were divided into three groups according to CR duration: up to acute phase (until discharge, Phase I group), up to recovery phase (≤150 days, Phase II group), and up to maintenance phase (>150 days, Phase III group). Using propensity score matching, mortality and major adverse cardiovascular events (MACE) were compared among the groups. RESULTS Follow-up period was 4.9 ± 3.0 years. Adult patients were divided into three groups (Phase I group: n = 4649, Phase II group: n = 3271, and Phase III group: n = 731). After propensity score matching, the risk of death and MACE was extremely lower in Phase III group than in Phase I or Phase II group (death: HR 0.47, P < 0.01, HR 0.64, P < 0.01, and MACE: HR 0.48, P < 0.01, HR 0.70, P < 0.01). Most patients in Phase II group had better survival than those in Phase I group. Subpopulations of female patients and those with dyslipidemia, smoking history, coronary artery bypass graft, or heart failure had better survival in Phase III group than in Phase II group. CONCLUSIONS Long-term supervised CR for patients with cardiovascular diseases is more effective than short-term CR.

中文翻译：

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长期心脏康复的大规模队列研究：一项前瞻性横断面研究。

背景技术很少有研究评估长期心脏康复（CR）的治疗效果，并且没有关于长期CR的大规模心血管事件调查的报道。方法这项队列研究纳入了2004年至2015年的9981例接受CR的患者。根据CR的持续时间，对CR进行监督的患者分为三组：急性期（直到出院，I期组），直至恢复期（≤150天） ，第二阶段组），直至维护阶段（> 150天，第三阶段组）。使用倾向评分匹配，比较各组的死亡率和主要不良心血管事件（MACE）。结果随访时间为4.9±3.0年。成年患者分为三组（第一阶段：n = 4649，第二阶段：n = 3271，第三阶段：n = 731）。倾向得分匹配后，第三阶段组的死亡和MACE风险远低于第一阶段或第二阶段组（死亡：HR 0.47，P <0.01，HR 0.64，P <0.01，以及MACE：HR 0.48，P <0.01，HR 0.70 ，P <0.01）。II期组的大多数患者的生存期均优于I期组。女性患者以及血脂异常，吸烟史，冠状动脉搭桥术或心力衰竭患者的亚群在III期组中的存活率高于II期组。结论对于心血管疾病患者，长期监督CR比短期CR更有效。II期组的大多数患者的生存期均优于I期组。女性患者以及血脂异常，吸烟史，冠状动脉搭桥术或心力衰竭患者的亚群在III期组中的存活率高于II期组。结论对于心血管疾病患者，长期监督CR比短期CR更有效。II期组的大多数患者的生存期均优于I期组。女性患者以及血脂异常，吸烟史，冠状动脉搭桥术或心力衰竭患者的亚群在III期组中的存活率高于II期组。结论对于心血管疾病患者，长期监督CR比短期CR更有效。