Geert Kleinnibbelink

Chapter 9 186 ABSTRACT Importance . Although exercise-based cardiac rehabilitation (CR) improves exercise capacity, quality of life and improves symptoms in patients with primary pulmonary hypertension (PH), little is unkown whether CR improves survival in patients with PH. Objective . To assess the association between exercise-based CR and mortality in patients with primary PH. Design, Setting, and Participants . In this retrospective observational cohort studies, patients with primary PH (aged ≥ 18 years) undergoing exercise-based CR and a propensity score-matched controlled without exercise-based CR were identified using anonymized data within a large electronical medical record of TriNetX, a global federated health research network with access to EMRs from participating academic medical centres, specialty physician practices, and community hospitals. Exposure . Exercise-based CR versus no exercise-based CR (controls). Main Outcomes and Measure s. 1-year mortality and hospitalisation. Results . We included 632 PH patients and 632 propensity-matched controls. Groups did not differ in age, sex, race, comorbidities, cardiovascular medication or cardiovascular procedures (all p > 0.05). CR was associated with a significantly lower 1-year mortality compared to controls (13.9% versus 21.0%; OR 0.60,.95% CI 0.45-0.81). CR was not related to different re-hospitalisation (OR 0.93, 95% CI 0.75-1.16), with re-hospitalisations rates of 55.4% in PH patients receiving CR and 57.1% in the controls. Conclusion and Relevance . This study, consisting of 1,264 patients with primary PH, suggests that CR is associated with 40% lower odds of 1-year mortality, when compared to propensity score-matched patients without CR or exercise programmes.