Key result
Cardiac rehabilitation is linked to a ~17 watt exercise capacity increase, modified by baseline depression and anxiety.
Why the study?
Do symptoms of depression and anxiety affect changes in exercise capacity and BMI during cardiac rehabilitation in patients with coronary artery disease?
Cohort (n=114)
Do symptoms of depression and anxiety affect changes in exercise capacity and BMI during cardiac rehabilitation in patients with coronary artery disease?
Absolute Event Rate: 144% vs 127%
p-value: p=<0.001
Depressive symptoms may impair improvement in exercise capacity during cardiac rehabilitation, potentially mitigating its cardiovascular benefits.
Baseline depression/anxiety symptoms may blunt exercise gains in cardiac rehab; leaves open whether screening or treatment improves outcomes in CAD.
BACKGROUND: To study whether symptoms of depression and anxiety would affect changes in exercise capacity and body mass index (BMI) during rehabilitation. DESIGN: Comprehensive cardiac outpatient rehabilitation intervention program. METHODS: We investigated exercise capacity, BMI, and symptoms of depression and anxiety before and after cardiac rehabilitation in 114 patients with coronary artery disease. The Hospital Anxiety and Depression Scale (HADS) was applied to assess symptoms of depression (HADS-D) and anxiety (HADS-A). RESULTS: Exercise capacity increased (127+/-47 vs. 144+/-51 watts, P<0.001) and symptoms of depression (4.0+/-3.6 vs. 2.7+/-2.7, P<0.001) and anxiety (5.4+/-4.4 vs. 4.1+/-3.6, P<0.001) decreased with the program, whereas BMI did not change. After controlling for covariates, HADS-D (r=-0.19, P=0.47) and HADS-A (r=0.17, P<0.09) correlated with change in exercise capacity. Change in HADS-A also correlated with that in exercise capacity (r=0.18, P<0.06). Changes in depression and anxiety were not significantly related to those in BMI. CONCLUSION: Symptoms of depression and anxiety affected change in exercise capacity during cardiac rehabilitation. Depressive symptoms may impair improvement in exercise capacity, thereby mitigating the cardiovascular benefit achieved by cardiac rehabilitation programs.
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Egger et al. (2008) conducted a cohort in coronary artery disease (n=114). Cardiac rehabilitation vs. Baseline (before rehabilitation) was evaluated on exercise capacity (watts) (p=<0.001). Cardiac rehabilitation increased exercise capacity from 127 to 144 watts (P<0.001), while baseline symptoms of depression and anxiety affected the magnitude of this improvement.
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