Key result
Following cardiac rehabilitation, patients treated with CABG showed greater improvements in mental health-related quality of life and depression compared to those treated with PCI.
Why the study?
Patients treated with CABG have a lower risk of MACE compared to PCI after revascularization, prompting a comparison of changes in psychological and cardiometabolic health indicators following cardiac rehabilitation between these groups.
Does cardiac rehabilitation yield different improvements in psychological health and quality of life in patients following CABG compared to PCI?
Cohort (n=278)
No
Does cardiac rehabilitation yield different improvements in psychological health and quality of life in patients following CABG compared to PCI?
Patients participating in cardiac rehabilitation following PCI appear to achieve smaller psychological health benefits compared with those recovering from CABG.
Answers are grounded in this paper and cite their sources.
CABG patients may experience greater mental health gains from cardiac rehabilitation than PCI patients; this observational association leaves open causal effects and practice implications.
Following coronary revascularization, patients treated with coronary artery bypass graft surgery (CABG) have lower risk of major adverse cardiovascular events when compared with those treated with percutaneous coronary intervention (PCI). We compared changes in cardiovascular risk factors, such as psychological and cardiometabolic health indicators, among patients who completed cardiac rehabilitation (CR) following CABG and PCI. Longitudinal records of 278 patients who completed an outpatient CR program following CABG or PCI were analyzed. We compared changes in anxiety and depression assessed by the Hospital Anxiety and Depression Scale (HADS); health-related quality of life (HR-QoL) measured by the Medical Outcomes Study Short Form-36 (SF-36); and indicators of cardiometabolic health (i.e., body mass, blood pressure, glucose, and lipid profiles) between CABG and PCI groups using analysis of covariance (ANCOVA). At baseline, patients treated with PCI (n = 191) had superior physical function (i.e., physical functioning: 62.5 ± 22.1 vs. 54.3 ± 23.0 points, p = 0.006; and role limitations due to physical health: 31.2 ± 36.8 vs. 20.6 ± 31.8 points, p = 0.024) when compared with those treated with CABG (n = 87). Following CR, patients treated with PCI showed significantly smaller improvements in depression (–0.4 ± 3.1 vs. –1.3 ± 2.7 points, p = 0.036) and mental HR-QoL (mental component summary: 2.4 ± 10.8 vs. 5.7 ± 10.7 points, p = 0.020) when compared with those treated with CABG. Novelty Patients with coronary artery disease treated with PCI have smaller functional limitations but similar psychological health when compared with those treated with CABG at CR enrollment. Patients participating in CR following PCI appear to achieve smaller psychological health benefits from CR when compared with those recovering from CABG.
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Montesano et al. (2020) conducted a cohort in Coronary heart disease (n=278). Coronary artery bypass graft surgery (CABG) vs. Percutaneous coronary intervention (PCI) was evaluated on Change in mental health-related quality of life (Mental Component Summary score) (p=0.020). Following cardiac rehabilitation, patients treated with CABG showed greater improvements in mental health-related quality of life and depression compared to those treated with PCI.
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