Physical and Psychosocial Effects of Cardiac Rehabilitation Participation in Patients With and those Without Coronary Artery Disease

Abstract Background: Patients participating in cardiac rehabilitation (CR) referred for coronary artery disease (CAD) diagnoses have improvements in physical capacity and psychological well-being. The primary Aim of Study: Aim of this study is to evaluate and compare exercise capacity and psychological well-being between patients referred to CR for CAD diagnoses and those referred for non-CAD diagnoses. Patients and Methods: Primary endpoint was improvement in 6-minute walking distance (6MWD). Secondary endpoints included change in exercise minutes per week (150 min-utes/week) (EMW 150), depression scores (PHQ9), anxiety scores (GAD7) and overall quality of life (COOP) scores. Results: Between January 2015 and February 2020, 617 patients completed the 12-week-CR program and were divided into: group I (referred for non-CAD diagnosis) (N=188) and group II (referred for CAD diagnosis) (N=429). At the com-pletion of their cardiac rehabilitation program, both groups improved their 6MWD without statistical difference (non-CAD group: +188 (110, 274) feet) vs. +200 (89, 290) feet in CAD group, p=0.86). Improvements in EMW 150 following CR were also similar between both groups (non-CAD group: (%) 54% vs. 51%, in CAD group, p= 0.75). Psychological health scores improved with reduction in GAD7, PHQ9 and COOP scores but changes in scores were not statistically different between both groups. PHQ9 categories showed a significant improvement in the moderate to severe category in patients referred for CAD patients. By adjusting for other covariates, CAD status was not associated with change in 6MWD. Conclusions: Patients referred to CR for non-CAD diag-noses showed a similar and non-inferior improvement in physical and psychological parameters as patients referred for CAD diagnoses. Clinical Implications: The study emphasizes the impor-tance of enrollment of patients in the CR for a wide spectrum of cardiac diseases including non-CAD in addition to CAD.