Cardiac rehabilitation outcomes in young patients with CABG and STEMI

Background: Cardiac rehabilitation (CR) is an evidence based complex program of recovery for patients with coronary artery bypass grafts (CABG) and ST-Elevation myocardial infarction (STEMI). However, its impact on young patients, particularly those with CABG, remains understudied. Methods: We compared consecutive young CABG and STEMI (males ≤50 years, females ≤55 years) patients in a single CR service in western Sydney, from 2001-2023. Comparative analyses included peak exercise capacity (METs), wait times, socio-demographic data, cardiovascular risk factors, quality of life (QOL), anthropometrics (BMI), heart disease complexity, and CR completion and outcomes. Results: This study included 298 CABG (45±5.1 years, 83% male) and 733 STEMI (44±5.5 years, 87% male) patients. Patients with CABG has significantly (p<0.001) longer wait times (CABG 23±10 days vs. STEMI 15±14 days), higher prevalence of 3-vessel disease (CABG 64% vs STEMI 11%), diabetes rates (CABG 32% vs STEMI 17%), lower baseline exercise capacity (CABG 8.2±2.3 METs vs STEMI 9.5±2.6 METs) and a lower rate of current smoking (CABG 37% vs STEMI 51%). Despite baseline disparities, no differences were found in CR completion rates (CABG 65% vs STEMI 59%, p=0.08), Notably, both groups also demonstrated significant improvements after CR in exercise capacity, QOL, mental health, and lipid profiles. Conclusions: Young CABG and STEMI patients have similar outcomes after CR despite baseline differences between the groups which are primarily related to disease complexity. These findings may add knowledge for their care in CR and for preventative measures.