Factors Associated With Change in Cardiovascular Fitness for Patients With Peripheral and Coronary Artery Disease in Cardiac Rehabilitation.

Purpose Cardiac rehabilitation (CR) yields improvements in cardiorespiratory fitness (peak oxygen uptake [VO2peak]). Predictors of change in VO2peak have been reported among patients with coronary artery disease (CAD) but have not been compared with peripheral artery disease (PAD). This study determined predictors of improved VO2peak among patients with PAD, CAD, and concomitant PAD and CAD (PAD/CAD) following a 6-mo home-based outpatient CR program (1supervised and 4 home weekly sessions). Methods This study was a retrospective (2006-2017) multiple linear regression analysis of CR patients with PAD (n = 63), CAD (n = 63), and PAD/CAD (n = 164). Peripheral artery disease and CAD were matched for age, sex, smoking status, diabetes, and year in program. Results Mean age of all patients was 68.9±10.1 yr, 72% were male, and mean improvement in VO2peak was 2.1 ± 3.3 mL/kg/min (14.5% improvement) following CR. In CAD, younger age (β= .30, P = .015), male sex (β = -.29, P = .019), and more recent year of entry (β = .26, P = .035) were predictors of improved VO2peak. In PAD, only male sex (β = -.36, P = .004) and in PAD/CAD, not having diabetes (β = -.24, P = .002), not smoking (β = -.25, P = .001), and shorter elapsed time from referring diagnosis to entry (β=-.19, P = .016) were predictors. Conclusions While younger age and male sex were predictors of improved VO2peak in CAD, age did not influence PAD, and neither age nor sex influenced PAD/CAD. Peripheral artery disease-related limitations may override some demographic factors, and strategies for improving VO2peak should be explored. Managing smoking and comorbid diagnoses including diabetes and a timely entry to CR may yield greater improvements in VO2peak among individuals with PAD.