Short-Term Outcomes According to Sex in a Real-World Cardiac Rehabilitation Program A Retrospective Cohort Study

Document Type : Original Article

Author

Graduate of the Master of Medical Sciences in Clinical Investigation Program, Harvard Medical School, Boston, MA, USA and The Department of Cardiovascular Medicine, National Heart Institute of Egypt

Abstract

Abstract
Background: Despite its proven benefits, cardiac rehabilitation (CR) remains markedly underutilized, particularlyamong eligible women. We sought to demonstrate whether women enrolled in a contemporary CR program derived similar benefits as men.

Aim of Study: In this study, we aimed to compare the changes in physical and psychosocial outcomes by sex after CR completion. We hypothesized that after participation in CR, women will demonstrate similar improvements in physical and psychological parameters to men.

Patients and Methods: Using a clinical registry of CR participants between January 2015 and February 2020 who completed a standard 12-week CR program, we analyzed changes in physical and psychosocial well-being parameters.
Primary endpoint was improvement in 6-minute walking distance (6MWD). Secondary endpoints included change in exercise minutes per week (EMW 150) (only patients with more than 150 minutes per week of reported exercise are included), depression scores (PHQ9), anxiety scores (GAD7), and overall quality of life (COOP) scores (lower scores are better) [1] .

Results: There were 617 patients (mean age 64±12 years, 26% women) with complete pre- and post-CR data. At baseline,
women had lower 6MWD, lower EMW150, higher GAD7, PHQ9, COOP, heart rate and LV EF. Women were more likely
to be referred following a valvular procedure and had fewer CABG. By the end of the CR program, women had similar
improvement in their 6MWD as men (women: Median (IQR): 14 [7,20] % (increase from baseline) vs. men: 13 [6,21] %
(increase from baseline), p-value=0.87). Women with mild anxiety improved significantly more than men (Table 3).

Conclusions: Women who completed a CR program derive similar physical benefits as men and may have greater psy-
chosocial well-being improvements. Efforts to increase CR participation should certainly target eligible women.

Clinical implications: Physical and psychosocial improvements observed in women completing CR are similar to men.
Efforts that increase women participation in CR need to be encouraged

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