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Introduction Health-related quality of life (HRQOL) has emerged as a valid and disease-specific outcome measure in cardiac patients. Cardiac rehabilitation (CR), a core component of secondary prevention, not only improves cardiovascular outcomes, but also HRQOL. Unfortunately, CR is still underutilized, especially among women and older patients. Aim of this study was to highlight age- and sex-specific effects of CR on HRQOL. Method A sample of 8286 patients (mean age 69.2±11.47 years; men 67.8±11.29, women 72.2±11.25) was analyzed. Patients were prospectively asessed from 2012 to 2018 in six Swiss CR clinics. HRQOL was measured at CR entry and discharge using the MacNew Heart Disease questionnaire. In multivariate analyses, we estimated sex- and age-specific changes in HRQOL during CR, adjusting for clinical characteristics. Results Women scored lower in any subdomain of HRQOL on admission to CR (social M = 5.05 (SD = 1.3); emotional M = 5.06±1.17; physical M = 4.36±1.72), compared to men (social M = 5.2±1.23); emotional M = 5.35±1.1; physical M = 4.43±1.76). Women showed greater improvement of social (F=10.98, p76 years) female sex predicted higher changes in emotional (F=10.878, p Conclusion Women report poorer HRQOL in all subdomains at CR entry compared to men, but in turn particularly benefit from CR in this regard. In older patients, this is particularly true for emotional HRQOL. Our results indicate that sex- and age-specific needs of cardiac patients should be considered during CR. Funding Acknowledgement Type of funding sources: None.

Aims Cardiac rehabilitation (CR), a key component of secondary prevention in cardiac patients, contributes fundamentally to improved cardiovascular health outcomes. Health-related quality of life (HRQOL) represents a widely employed outcome measure in CR, yet, its predictive properties on exercise capacity change during CR are poorly understood. Aim of this study was to examine the association between baseline HRQOL and its subdomains on improvement of exercise capacity during CR. Methods Study participants were 13,717 inpatients of six Swiss CR clinics from 2012 to 2018. We measured HRQOL at admission to CR with the MacNew Heart (MNH) questionnaire and exercise capacity at admission and discharge using the six-minutes walking test (6MWT). Following factorial analyses, we performed univariate and multivariate analyses to test the predictive properties of baseline global HRQOL and its domains for improvement in exercise capacity, adjusting for demographic and clinical characteristics. Results Mean improvement in 6MWT was 114 meters (SD=90), achieved after 17.4 days (SD=5.5). Lower emotional HRQOL (b=7.85, p≤0.001, 95% CI [−5.67, 10.03]) and higher physical HRQOL (b=−5.23, p Conclusion Patients entering CR with low emotional and high physical HRQOL are at risk for a lower gain in exercise capacity during CR. Global MNH alone does not provide a reliable assessment of HRQOL; thus a focus on specific domains of HRQOL is needed. Funding Acknowledgement Type of funding sources: None.