Are cardiac risk stratification protocols effective in predicting complications while conducting a cardiovascular rehabilitation program?

Author(s)

Felipe Ribeiro

• Document type: Master's Dissertation
• Press: Presidente Prudente. 2020-02-14.
• Institution: Universidade Estadual Paulista (Unesp). Faculdade de Ciências e Tecnologia. Presidente Prudente
• Defense date: 2020-02-06
• Advisor: Luiz Carlos Marques Vanderlei

Abstract

Cardiovascular rehabilitation programs (CRP) are important for cardiac patients in general and individuals with cardiovascular risk factors, however, they can be associated with the risk of the appearance of signs and symptoms during their development, and, investigate possible factors that may predict the the possibility of these during its performance, such as stratification of cardiac risk, is extremely important in the clinical setting. Objectives: Evaluate the accuracy of risk stratification protocols in predicting signs and symptoms during the performance of a CRP. Materials and Methods: Cardiac risk stratifications were performed in 7 different protocols of 80 patients treated at a CRV and followed for a period of 24 sessions to assess signs and symptoms. The normality of the data was verified by the Shapiro-Wilk test and the relationship between the number of complications of the patients and the risk stratifications was analyzed by the Pearson/Spearman correlation. Sensitivity, specificity and accuracy for the occurrence of events were evaluated. The area under the curve was considered significant when values ≥ 0.650 were obtained. All results were discussed at the 5% significance level. Results: No significant correlations were found between the occurrence of signs and symptoms and the cardiac risk stratification protocols (p> 0.05). The American Heart Association (AHA) protocol showed better accuracy (0.61 [0.49 - 0.73]) and specificity (0.67 [0.35 - 0.90]). The protocol of the French Society of Cardiology (SFC), presented the best results for sensitivity (0.59 [0.48 - 0.73]). Conclusion: The evaluated protocols do not present significant correlations between risk classes and the occurrence of signs and symptoms during PRCV, however their use in these programs is still extremely important for the management and safety of patients. (AU)

• FAPESP's process: 18/07587-0 - The protocols of cardiac risk stratification are effective to prevent INTERCORRENCES during the realization of a Cardiovascular Rehabilitation program?
• Grantee: Felipe Ribeiro
• Support Opportunities: Scholarships in Brazil - Master