To clarify the relationship between protein intake during hospitalization and the effectiveness of ambulatory CR in patients participating in cardiac rehabilitation.
This retrospective cohort study included patients who were hospitalized for cardiovascular disease (heart failure, coronary artery disease, post-cardiac surgery) and participated in ambulatory CR (August 2021 to November 2022) after discharge at Kyorin University Hospital between August 2021 and November 2022. A total of 51 patients were included in this study, and we categorized patients into two groups based on their protein intake during hospitalization (average of a week prior to discharge): high-protein group [HP] (≥1.0 g/kg/day) and low-protein group [LP] (1.0 g/kg/day). After adjusting for confounding factors using propensity score matching, physical function and exercise tolerance at the end of ambulatory CR were compared between the two groups. Each outcome was evaluated by calculating the percentage change in values before and after the completion of ambulatory CR. For measures related to speed, a negative change indicates improvement, while for measures related to exercise tolerance, a positive change indicates improvement. This study was approved by the Ethics Committee of the Kyorin University School of Medicine (Ethics No. R05-155). This study was conducted in accordance with the Declaration of Helsinki and the Ethical Guidelines for Medical and Health Research Involving Human Subjects.
Propensity score matching resulted in the creation of 10 pairs. The median age of the participants was 63 (56 - 65) years in the LP group and 56 (53 - 64) years in the HP group. The gender distribution was 7 males in the LP group and 8 males in the HP group. The high-protein group showed significantly greater improvements in the 5-times sit-to-stand test (LP: -2 [-5 to 2] % vs HP: -12 [-27 to -6] %; P = 0.03) and peak VO2 (LP: 4 [-6 to 17] % vs HP: 18 [14 to 33] %; P = 0.04) at the end of ambulatory CR.
These findings suggest that in patients with cardiovascular disease, sufficient protein intake during hospitalization may lead to greater improvements in physical function, such as lower limb muscle strength and walking ability, as well as exercise tolerance at the end of ambulatory CR.
It is important for patients with cardiovascular disease to ensure adequate protein intake during hospitalization, and if intake is insufficient, nutritional guidance should be provided during ambulatory CR.
protein intake
ambulatory
