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Montesano M, Reed JL, Tulloch HE, Pipe AL, Terada T. Cardiac rehabilitation is associated with greater improvements in psychological health following coronary artery bypass graft surgery when compared with percutaneous coronary intervention. Appl Physiol Nutr Metab 2020; 45:1339-1344. [PMID: 32544341 DOI: 10.1139/apnm-2020-0213] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Following coronary revascularization, patients treated with coronary artery bypass graft surgery (CABG) have lower risk of major adverse cardiovascular events when compared with those treated with percutaneous coronary intervention (PCI). We compared changes in cardiovascular risk factors, such as psychological and cardiometabolic health indicators, among patients who completed cardiac rehabilitation (CR) following CABG and PCI. Longitudinal records of 278 patients who completed an outpatient CR program following CABG or PCI were analyzed. We compared changes in anxiety and depression assessed by the Hospital Anxiety and Depression Scale (HADS); health-related quality of life (HR-QoL) measured by the Medical Outcomes Study Short Form-36 (SF-36); and indicators of cardiometabolic health (i.e., body mass, blood pressure, glucose, and lipid profiles) between CABG and PCI groups using analysis of covariance (ANCOVA). At baseline, patients treated with PCI (n = 191) had superior physical function (i.e., physical functioning: 62.5 ± 22.1 vs. 54.3 ± 23.0 points, p = 0.006; and role limitations due to physical health: 31.2 ± 36.8 vs. 20.6 ± 31.8 points, p = 0.024) when compared with those treated with CABG (n = 87). Following CR, patients treated with PCI showed significantly smaller improvements in depression (-0.4 ± 3.1 vs. -1.3 ± 2.7 points, p = 0.036) and mental HR-QoL (mental component summary: 2.4 ± 10.8 vs. 5.7 ± 10.7 points, p = 0.020) when compared with those treated with CABG. Novelty Patients with coronary artery disease treated with PCI have smaller functional limitations but similar psychological health when compared with those treated with CABG at CR enrollment. Patients participating in CR following PCI appear to achieve smaller psychological health benefits from CR when compared with those recovering from CABG.
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Affiliation(s)
- Matthew Montesano
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, ON K1Y 4W7, Canada.,Department of Surgery, Amsterdam UMC, Location VU University Medical Centre, Amsterdam 1081 HV, the Netherlands
| | - Jennifer L Reed
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, ON K1Y 4W7, Canada.,Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada.,School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1Y 4W7, Canada
| | - Heather E Tulloch
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, ON K1Y 4W7, Canada.,Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada
| | - Andrew L Pipe
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, ON K1Y 4W7, Canada.,Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada
| | - Tasuku Terada
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, ON K1Y 4W7, Canada
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