Cited by 60Cardiac Health and Mental HealthMedical Practices and RehabilitationDiabetes, Cardiovascular Risks, and Lipoproteins

Cardiac rehabilitation completion is associated with reduced mortality in patients with diabetes and coronary artery disease

Open access
Armstrong, Marni J., Sigal, Ronald J., Arena, Ross, Hauer, Trina L., Austford, Leslie D., Aggarwal, Sandeep, Stone, James A., Martin, Billie-Jean·2015·Diabetologia

Abstract

Aims Cardiac rehabilitation (CR) reduces the risks of mortality and hospitalisation in patients with coronary artery disease and without diabetes. It is unknown whether patients with diabetes obtain the same benefits from CR. Methods We retrospectively examined patients referred to a 12 week CR programme between 1996 and 2010. Associations between CR completion vs non-completion and death, hospitalisation rate and cardiac hospitalisation rate were assessed by survival analysis. Results Over the study period, 13,158 participants were referred to CR (mean ± SD, age 59.9 ± 11.1 years, 28.9% female, 2,956 [22.5%] with diabetes). Patients with diabetes were less likely to complete CR than those without diabetes (41% vs 56%, p < .0001). Over a median follow-up of 6.6 years, there were 379 deaths in patients with diabetes vs 941 deaths among those without diabetes (12.8% vs 8.9%). Of the non-completers, patients with diabetes had a higher mortality rate compared with those without diabetes (17.7% vs 11.3%). In patients who completed CR, mortality was lower: 11.1% in patients with diabetes vs 7.0% in those without diabetes. In patients with diabetes, CR completion was associated with reduced mortality (HR 0.46 [95% CI 0.37, 0.56]), reduced hospitalisation (HR 0.86 [95% CI 0.76, 0.96]) and reduced cardiac hospitalisation (HR 0.67 [95% CI 0.54, 0.84]). The protective associations were similar to those of patients without diabetes. In multivariable adjusted analyses, all of these associations remained significant. Conclusions Patients with diabetes were less likely to complete CR than those without diabetes. However, patients with diabetes who completed CR derived similar apparent reductions in mortality and hospitalisation to patients without diabetes.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1007/s00125-015-3491-1

Cites

44 of 44 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Authors
Armstrong, M. J., Sigal, R. J., Arena, R., Hauer, T. L., Austford, L. D., Aggarwal, S., Stone, J. A., & Martin, B.-J.
Affiliations
  • University of Calgary (CA)
  • University of Illinois Chicago (US)
Corresponding author
Armstrong, Marni J.
Venue
Diabetologia
Published
2015-01-26
Volume
58
Issue
4
Pages
691-698
ISSN
  • 0012-186X (ISSN-L)
  • 1432-0428
OpenAlex
W2004189364
Cited by
60
References
44
Citations by year
2025: 1 · 2024: 4 · 2023: 6 · 2022: 5 · 2021: 4 · 2020: 6 · 2019: 10 · 2018: 8 · 2017: 6 · 2016: 7 · 2015: 3
FWCI
5.87
Type
journal article
Language
en
Open access
Locations
  • Diabetologia (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Eli Lilly and Company
  • Alberta Health Services
  • Alberta Innovates
  • Servier
  • Eli Lilly Canada
  • Canadian Institutes of Health Research
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
  • Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords
cardiac rehabilitation, diabetes mellitus, coronary artery disease, rehabilitation completion, mortality, hospitalization
MeSH terms
Aged, Coronary Artery Disease, Diabetes Mellitus, Diabetic Angiopathies, Female, Hospitalization, Humans, Male, Middle Aged, Patient Compliance, Retrospective Studies, Risk Factors, Time Factors, Multivariate Analysis, Chi-Square Distribution, Proportional Hazards Models, Treatment Outcome, Kaplan-Meier Estimate, Protective Factors

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review