Effect Of A Contemporary Cardiac Rehabilitation Program On Self-reported Health Status: Myocardial Infarction Versus Bypass Surgery Patients

Abstract

Substantial changes occurred in the core components of cardiac rehabilitation (CR) during the 1990s and first decade of the new millennium. These changes have raised concerns about the relevance of findings from earlier studies on the effect of early outpatient CR (Phase 2 CR) on various outcome measures, including self-reported health status. PURPOSE: In this multicenter study, we investigated the effect of a contemporary phase 2 CR program on self-reported health status 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: Self-reported health status was assessed using the SF-36 at baseline and after approximately 12 weeks of participation in a contemporary phase 2 CR program. RESULTS: On program exit, improvements (p<0.05 for within group change from baseline) in SF-36 transformed scores were observed, as follows: physical functioning (Group A, 13; Group B, 19); role-physical (Group A, 35; Group B, 41); bodily pain (Group A, 13; Group B 22); general health (Group A, 4; Group B, 3); vitality (Group A, 10; Group B, 12); social functioning (Group A, 17; Group B, 23); role-emotional (Group A, 12; Group B, 16); and mental health (Group A, 6; Group B, 6). With the exception of general health (slightly greater improvement in Group A versus Group B patients) and mental health (no difference between groups), the magnitude of improvement from baseline was significantly greater (p<0.05) for Group B versus Group A patients. CONCLUSION: These data serve to document the magnitude of improvement in self-reported health status in post-myocardial infarction and post-coronary artery bypass graft surgery patients in response to participation in a contemporary phase 2 CR program. The data demonstrate that both groups of patients experience significant improvements in multiple indices of self-reported health status and that the magnitude of improvement differs for certain indices in post-myocardial infarction versus postcoronary artery bypass graft surgery patients.