NEW YORK (Reuters Health) - Patients who underwent a procedure to widen their coronary arteries, then followed up with cardiac rehabilitation, were nearly half as likely to die within six years as patients who didn't do the rehab, a new study found.
The results, published in the journal Circulation, are in line with earlier research showing that cardiac rehabilitation can benefit people after heart procedures.
In this study, researchers at the Mayo Clinic in Rochester, Minnesota, followed patients for an average of six years after they underwent angioplasty, also called percutaneous coronary intervention (PCI).
More than 1.3 million people in the United States have an angioplasty procedure each year to open up clogged arteries.
Cardiac rehab involves an exercise regimen, regular visits with a health provider, nutrition counseling, lifestyle changes and taking prescribed medications.
The researchers looked at the medical records of 2,400 patients who underwent angioplasty at the Mayo Clinic between 1994 and 2008.
In one analysis, they compared two groups of just over 700 patients each, whose members were matched by age, sex, weight and other health factors.
Of the 719 patients who went through rehab, 83 died during the follow up period, versus 139 of the 719 patients who did not go through rehab.
After the researchers adjusted for some small differences between the two groups, they concluded that those who participated in a cardiac rehab program were 46 percent less likely to die during the follow up period.
Dr. Randal Thomas, the senior author of the study and the director of the Cardiovascular Health Clinic at the Mayo Clinic, said he was surprised at just how large the reduction in the risk of dying was between patients who went through rehab and those who didn't.
"It's important to recognize the significant benefits of cardiac rehabilitation even after PCI," Thomas said. "We sometimes still have the impression that a patient is cured after PCI, but there's still quite a bit of work to be done after PCI."
Thomas's results show a larger difference than some other research covering heart patients undergoing a wider variety of procedures.
For instance, a study published in 2009 by Dr. Jose Suaya, a visiting scholar at Brandeis University and a researcher at GlaxoSmithKline, found that patients who had major coronary procedures were 26 to 34 percent less likely to die within five years if they participated in cardiac rehab.
"Generally, people who undergo PCI are thought to be relatively healthier than, say, (those who undergo) bypass, so we were anticipating the impact would be smaller than for other groups of patients," Thomas told Reuters Health.
Suaya, who was not involved in the new study, said he was not surprised that it found cardiac rehab was tied to a lower risk of dying after angioplasty.
"There is the rationale that someone engaging in exercise and regular visits with a provider would do better than someone who doesn't exercise or visit a provider regularly," Suaya told Reuters Health.
The level of participation in cardiac rehab, however, tends to be below what Suaya would like to see.
Among the Mayo patients included in the current study, four out of every ten angioplasty recipients participated in a rehab program.
Other studies in recent years have found that perhaps half of patients get referrals for cardiac rehabilitation from their doctors following heart procedures or heart attacks, and of those referred, less than half actually enroll.
"We need to increase utilization," Suaya said.
Suaya said doctors should be consistently referring patients to rehab programs, and any financial barriers to patients should be reduced.
SOURCE: http://bit.ly/mnbdZ0 Circulation, May 31, 2011.
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