Key result
Cardiac rehabilitation improved cardiovascular risk factors and exercise capacity (P<0.05), with a 7.8% hospital readmission rate and 97.5% survival rate over a median 2.99 years.
Why the study?
Does a comprehensive cardiac rehabilitation program improve cardiovascular risk factors and exercise capacity in cardiac patients?
Cohort (n=499)
No
Does a comprehensive cardiac rehabilitation program improve cardiovascular risk factors and exercise capacity in cardiac patients?
p-value: p=<0.05
A comprehensive cardiac rehabilitation program significantly improves cardiovascular risk factors and exercise capacity, with female sex and diabetes identified as predictors of subsequent hospital readmission.
Supports CR benefits in this cohort; leaves open need for RCTs to confirm generalizability and readmission predictors.
BACKGROUND: Despite the positive outcomes reported with cardiac rehabilitation (CR), its impacts have been reported to be different from a region or country to another, which may be due to the different contents of rehabilitation programs. OBJECTIVES: To investigate the effect of CR on cardiovascular risk factors. PATIENTS AND METHODS: This is a retrospective cohort study on the data from Imam Ali Cardiac Rehabilitation Center in Kermanshah province, Iran from 2001 to 2008. We used paired t-test to evaluate the effect of CR on cardiovascular risk factors. Logistic regression or t-test (unequal variance) were used to assess the factors influencing re-admission (due to cardiac problems). The relationship between different variables and death was studied using univariate cox proportional hazard. P values < 0.05 were considered significant for all analyses. RESULTS: Out of 504 patients who completed rehabilitation, a total of 499 were analyzed. These 499 patients consisted of 383 men and 116 women. All anthropometric measurements, blood lipids (except HDL cholesterol), systolic and diastolic blood pressure, depression, anxiety and exercise capacity improved after rehabilitation (P < 0.05 for all cases). The improvement was observed in both sexes. A total of 39 patients were re-admitted to hospital after rehabilitation. Being female (OR = 2.40; 95%CI: 1.22-4.68) and history of diabetes (OR = 2.04; 95%CI: 1.04-4.02) increased the risk of re-admission significantly. Patients who were readmitted had higher anthropometric measurements at the beginning and the end of the program. Moreover, the initial exercise capacity of readmitted patients was lower than those who were not readmitted. After a maximal follow-up period of 6.3 years (median = 2.99 years), only eight patients expired (survival rate: 97.5%; 95%CI: 94.7-98.8). None of the variables in our study was significantly related to the survival rate. CONCLUSIONS: The comprehensive CR program in Imam Ali Center efficiently reduces cardiovascular risk factors and improves exercise capacity.
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Najafi et al. (2014) conducted a cohort in Patients completing cardiac rehabilitation (n=499). Cardiac rehabilitation vs. Baseline (pre-rehabilitation) was evaluated on Cardiovascular risk factors and exercise capacity (p=<0.05). Cardiac rehabilitation improved cardiovascular risk factors and exercise capacity (P<0.05), with a 7.8% hospital readmission rate and 97.5% survival rate over a median 2.99 years.
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