January 1, 2007
View Full PaperOutcomes at One-Year Follow-up of Women and Men With Coronary Artery Disease Discharged From Cardiac Rehabilitation
Key Result
Improvements in clinical, behavioral, and health status variables attained during cardiac rehabilitation were largely maintained at 1-year follow-up in both men and women.
Key Points
- This research aims to assess the long-term maintenance of benefits from cardiac rehabilitation in patients with coronary artery disease, focusing on gender differences.
- Analyzed one-year follow-up data from 244 of 533 patients with coronary artery disease discharged from cardiac rehabilitation.
- Compared changes in clinical, behavioral, and health status measures from baseline to CR completion and to one-year follow-up.
- Examined data separately for men and women.
- Statistically significant improvements were sustained at one-year follow-up for most measures, except high-density lipoprotein cholesterol and smoking cessation.
- Women showed better retention and implementation of dietary advice compared to men over the long term.
- Both genders exhibited similar levels of long-term benefits from cardiac rehabilitation, indicating a general effectiveness of the program.
Study Design
Type
Cohort (n=244)
Structured PICO
Does cardiac rehabilitation improve long-term clinical, behavioral, and health status variables in men and women with coronary artery disease?
P
Population
244 patients with coronary artery disease (mean age 62, 30% women) discharged from cardiac rehabilitation, followed for 1 year.
E
Exposure
Cardiac rehabilitation (CR)
C
Comparator
Baseline (pre-CR) and CR completion
O
Outcome
Changes in clinical, behavioral, and health status variables from baseline to 1-year follow-upsurrogate
Benefits achieved during cardiac rehabilitation in patients with CAD are largely maintained at 1 year in both men and women, though some attrition occurs.
Abstract
In Brief INTRODUCTION: Little is known about which benefits achieved during cardiac rehabilitation (CR) are maintained 1 year after CR discharge and whether there are any gender-specific differences. METHODS: One-year follow-up data were available in 244/533 (46%; mean age 62 ± 11 years, 30% women, 30% nonwhite) patients with coronary artery disease discharged from CR between 1996 and 2005. We compared changes in clinical, behavioral, and health status variables from baseline to CR completion, CR completion to 1-year follow-up, and baseline to 1-year follow-up for the group overall and separately for men and women. RESULTS: At CR completion, statistically significant improvements from baseline were seen in all measures except for high-density lipoprotein cholesterol and smoking. Compared with baseline, these improvements were sustained at 1 year, albeit with some attrition compared with the benefits achieved at CR completion. Long-term benefits were generally similar in women and men, although women appeared to have better long-term retention and implementation of dietary advice. CONCLUSION: Improvements in most measures attained during CR were still evident at 1 year in both men and women. Whether reinforcement CR sessions or other strategies to enhance long-term adherence to lifestyle changes could attenuate the observed attrition in benefits needs further study. Gender-specific strategies may best address the needs of men and women. In our study of patients with coronary artery disease, cardiac rehabilitation (CR) completion was associated with significant improvement in clinical, behavioral, and health status variables. This improvement was maintained at 1-year follow-up for most variables, although there was some attrition of benefit from CR completion to 1 year. Women maintained gains achieved in CR to a similar degree as men for most outcomes studied, although women had better long-term retention of dietary advice compared with men. Gender-specific research is needed to guide interventions that meet the needs of both men and women.