Clinical Effectiveness of a Contemporary Cardiac Rehabilitation Program in Myocardial Infarction Versus Bypass Surgery Patients

Abstract

Significant changes in the core components of cardiac rehabilitation (CR) during the past two decades raise questions about the relevance of findings from earlier studies on the clinical effectiveness of early outpatient CR (Phase 2 CR) in various patient populations. PURPOSE: In this multicenter study, we investigated the effect of a contemporary phase 2 CR program on multiple cardiovascular disease (CVD) risk factors in 4,791 post-myocardial infarction patients (Group A, n=2,154) versus post-coronary artery bypass graft surgery patients (Group B, n=2,637). METHODS: Outcome measures were evaluated at baseline and after approximately 12 weeks of participation in a contemporary phase 2 CR program. RESULTS: On program exit, improvements (p<0.05) in multiple CVD risk factors were observed for patients in both groups who had abnormal baseline risk factor values (based on national clinical guidelines), as follows: systolic/diastolic blood pressure (Group A, −20/17 mmHg; Group B, −19/17 mmHg); LDL cholesterol (Group A, −34 mg/dl; Group B, −33 mg/dl); HDL cholesterol (Group A, 5 mg/dl; Group B, 4 mg/dl); triglycerides (Group A, −55 mg/dl; Group B, −47 mg/dl); fasting glucose (Group A, −15 mg/dl; Group B, −11 mg/dl); and body weight (Group A, −5 lbs; Group B, −3 lbs). With the exception of body weight (greater reduction in Group A versus Group B, p<0.05), no other statistically significant differences were observed for Group A compared with Group B. CONCLUSION: These data serve to document the magnitude of improvement in multiple CVD risk factors in post-myocardial infarction and post-coronary artery bypass graft surgery patients. Our findings demonstrate that both groups of patients experience substantial improvements in abnormal baseline risk factor values following a contemporary phase 2 CR program.