Clinical research studyImpact of Cardiac Rehabilitation on Depression and Its Associated Mortality
Section snippets
Patients
We retrospectively evaluated 522 consecutive patients who were referred to, attended, and completed phase II cardiac rehabilitation (treatment group) between January 2000 and July 2005. All patients entered the program 2-6 weeks after a coronary event, including acute MI (30%), coronary bypass surgery (35%), and percutaneous coronary intervention (44% of patients; some patients had more than one clinical event). We further evaluated a control group of 179 patients who entered rehabilitation but
Baseline Characteristics
The mean age of the 701 patients in treatment and control groups was 64 ± 11 years, with 72% of the subjects male. The mean ejection fraction was 54 ± 12%, and the mean peak VO2 was 16.2 ± 5.2 mL/kg/min. Depressive symptoms were identified in 139 patients (20%) on entry into rehabilitation (26% controls, 17% treatment; P = .005). Table 1 highlights the baseline differences between treatment and control subjects. Table 2 outlines the baseline differences between treatment and control depressed patients.
Treatment Group Characteristics and Effects of Cardiac Rehabilitation and Exercise Training
Discussion
There are several important implications of this study. First, depressive symptoms are prevalent in the coronary heart disease population, particularly in patients following major coronary events. Second, the presence of depressive symptoms, regardless of age or sex, confers a marked increase in all-cause mortality risk over time. Third, cardiac rehabilitation is associated with a marked reduction in the prevalence of depressive symptoms corresponding to a significant improvement in survival.
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