Cardiac rehabilitation in older populations - never too late to rehabilitate

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Age is one of the most determinant cardiovascular risk factors and the prevalence of cardiovascular disease is higher after 70 years old. Referral to cardiac rehabilitation programs for elder individuals is often overlooked since such patients are deemed as frail, high risk and may show lack of competence when attending these programs. Purpose To assess differences in clinical characteristics and outcomes between pts >70 years old with younger ones. Methods Prospective cohort study which included consecutive pts who were participating in a centre-based CR program lasting 8-12 weeks from 2019 to 2021. We analysed prevalence of risk factors, lab echocardiographic and CPET data in women who were enrolled in the program. Statistical analysis was performed with Chi-square and Wilcoxon tests. Results From a pool of 349 patients, only 74 (21%) were 70 or more years old. In this group most of pts were male (90,5%), mean age of 75,2 +- 4,34 year-old. 90% pts had arterial hypertension (n=67), 76% had dyslipidemia, 34% were diabetic and 57,5% were smokers or past smokers. Most patients were in NYHA II (64,2%) and the remainder in NYHA I (29,9%) and III (6%). Mean ejection fraction was 52 +- 14%. NTproBNP in first evaluation 1335 pg/mL, LDL-c 80,4mg/dL and HDL 46,8%. Both groups (<70 and >70years) were relatively homogeneous, except for differences in sex (male sex mor prevalent (p=0.019) and hypertension (p=0.006). Interestingly there were no significant differences in both groups regarding hospital admissions, rate of reinfarction and cardiovascular death. In both groups we noted a significant improvement in echo and CPET, reaching statistical significance in ejection fraction variation (p=0.01), duration of CPET (p=0.048) workload peak; however, in contrast to younger patients, VO2 peak improvement was non significative. Conclusions Although there is a higher prevalence in cardiovascular disease among older people, CR referral is far lower. As we can see, such interventions are safe and effective also in older pts and thus we should identify factors going against their inclusion in CR programs and prioritize risk stratification.