The role of cardiac rehabilitation in secondary prevention after coronary events

Eur J Prev Cardiol. 2017 Sep;24(13):1360-1368. doi: 10.1177/2047487317719355. Epub 2017 Jun 30.

Abstract

Background Coronary risk factor control in Europe is suboptimal and there are large variations in the nature of cardiac rehabilitation (CR) programmes offered to coronary heart disease patients. We aim to explore characteristics and risk factor control in patients recruited from two neighbouring hospitals offering CR with different content. Methods In a cross-sectional study, 1127 Norwegian patients hospitalized with acute myocardial infarction and/or a revascularization procedure attended a clinical visit and completed a questionnaire at 2-36 months' follow-up. The hospital of Vestfold provides comprehensive CR, while the hospital of Drammen provides mainly exercise-based CR. Results At follow-up, patients in Vestfold performed more physical activity ( p = 0.02), were less obese ( p = 0.02) and reported better medication adherence ( p = 0.02) than patients in Drammen. The perceived need for information and follow-up was higher in Drammen than Vestfold ( p < 0.001). The CR participation rate in Vestfold was 75% compared with 18% in Drammen. CR participation in Vestfold was associated with higher prevalence of smoking cessation ( p = 0.001), lower low-density lipoprotein cholesterol ( p = 0.01) and better medication adherence ( p = 0.02) compared with non-CR, in adjusted analyses. No differences in diet, body weight, or blood pressure control were found between CR and non-CR. Conclusions Vestfold, with comprehensive CR, had a higher participation rate and more risk factors on target than Drammen. Participation in CR in Vestfold was associated with higher levels of smoking cessation and medication adherence, and lower low-density lipoprotein cholesterol, but overall risk factor control is still deficient, underlining the need for improved understanding of barriers to optimal risk factor control.

Keywords: Secondary prevention; cardiac rehabilitation; coronary heart disease patients; drug adherence; information; lifestyle changes; risk factor control.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cardiac Rehabilitation / methods*
  • Cause of Death / trends
  • Cross-Sectional Studies
  • Exercise / physiology*
  • Exercise Therapy / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Medication Adherence*
  • Middle Aged
  • Morbidity
  • Myocardial Infarction / epidemiology
  • Myocardial Infarction / rehabilitation*
  • Norway / epidemiology
  • Risk Factors
  • Risk Reduction Behavior*
  • Secondary Prevention / methods*
  • Survival Rate / trends
  • Young Adult