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Brazilian Journal of Cardiovascular Surgery

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SPECIAL ARTICLES • Rev Bras Cir Cardiovasc 29 (2) • Apr-Jun 2014 • https://doi.org/10.5935/1678-9741.20140067 copiar

Estratificação de risco cardíaco em programas de reabilitação cardíaca: revisão de protocolos

Autoria SCIMAGO INSTITUTIONS RANKINGS

Objetivo:

Reunir e descrever características gerais dos diferentes protocolos de estratificação de risco existentes para cardiopatas submetidos ao exercício.

Métodos:

Realizou-se busca nas bases eletrônicas LILACS, IBECS, MEDLINE, Biblioteca Cochrane, SciELO, por meio dos descritores: Doenças cardiovasculares, Centros de Reabilitação, Guia de Prática Clínica, Exercício e Estratificação de Risco e a palavra-chave "Risk Stratification", nos últimos 20 anos.

Resultados:

Foram selecionados oito trabalhos abordando métodos de estratificação de risco em indivíduos submetidos a exercício.

Conclusão:

Nenhum dos métodos descritos conseguiu abranger todas as situações de risco a que o paciente está sujeito, porém eles são fundamentais para prescrição do exercício.

Doenças Cardiovasculares; Centros de Reabilitação; Guia de Prática Clínica; Exercício; Medição de Risco

Protocol	General Characteristics	Classification
ACSM (2007)	Targeted at any individual who wants to perform an exercise program. Uses the presence of risk factors, signs and symptoms of cardiovascular, metabolic, and respiratory diseases as risk selection criteria. it does not discuss results of additional tests for stratification.	Low, moderate and High Risk.
SBC (2013)	Targeted at those who have suffered AMI and it uses the maximal exercise test as a primary method of risk stratification. It also uses the presence of signs and symptoms of congestive heart failure in high-risk individuals. It considers as high risk those individuals with functional capacity = 5 METs and EF = 35%.	Low, moderate and High Risk.
AHA (2001)	Extensive method that uses mainly symptoms or the presence of heart disease, risk factors, and exercise testing for risk selection. It considers as high risk those individuals with functional capacity <6 METs and EF ≤ 30%.	Risk Classes (A, B, C and D).
PASHKOW (1993)	Targeted at those who have suffered AMI. It uses results of complementary tests to stratify risk. It considers as high risk for events those individuals with functional capacity ≤ 4.5 METs. It does not use EF as criteria.	Low, moderate and High Risk.
AACVPR (2007)	It uses the maximal exercise test as the primary method of risk stratification (presence of symptoms during stress or recovery test). Their absence may inappropriately categorize the individual. Targeted at those who have suffered AMI. It considers as high risk those individuals with functional capacity <5 METs and EF <40%.	Low, moderate and High Risk.
SFC (2002)	Targeted at those who have suffered AMI based mainly on clinical history and maximal exercise test. It considers at high-risk individuals with functional capacity <5 METs and EF <30%.	Low, moderate and High Risk.
SEC (2000)	Designed for individuals who have suffered AMI. It uses clinical data and tests such as echocardiography and exercise testing to define risk groups. It considers as high risk those individuals with functional capacity <5 METs and EF <35%.	Low, moderate and High Risk.
SEC (2000)	Designed for individuals who have suffered AMI and wish to participate in sports activities. It evaluates VO₂max associated with age to designate METs value in low-risk individuals. It considers as high risk those individuals with EF <50%.	Low and High Risk.

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