Adverse psychological and coronary risk profiles in young patients with coronary artery disease and benefits of formal cardiac rehabilitation

Lavie, Carl J. and Milani, Richard V. (2006). Adverse psychological and coronary risk profiles in young patients with coronary artery disease and benefits of formal cardiac rehabilitation. In: 77th Scientific Meeting of the American Heart Association, New Orleans, LA, United States, (1878-1883). 7-10 November 2004. doi:10.1001/archinte.166.17.1878

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Author Lavie, Carl J.
Milani, Richard V.
Title of paper Adverse psychological and coronary risk profiles in young patients with coronary artery disease and benefits of formal cardiac rehabilitation
Conference name 77th Scientific Meeting of the American Heart Association
Conference location New Orleans, LA, United States
Conference dates 7-10 November 2004
Journal name Archives of Internal Medicine   Check publisher's open access policy
Place of Publication Chicago, IL, United States
Publisher American Medical Association
Publication Year 2006
Sub-type Fully published paper
DOI 10.1001/archinte.166.17.1878
ISSN 0003-9926
1538-3679
Volume 166
Issue 17
Start page 1878
End page 1883
Total pages 5
Language eng
Formatted Abstract/Summary
Background Recent data indicate that young patients with coronary artery disease (CAD) have a poor long-term prognosis. Although the benefits of formal cardiac rehabilitation and exercise training programs are well established, most of these data come from middle-aged and older patients.
Methods We assessed baseline behavioral data, quality of life, and risk profiles in 635 consecutive patients with CAD before and after cardiac rehabilitation and exercise training, and specifically assessed data in 104 young patients (mean ± SD age, 48 ± 6 years; range, 22-54 years) compared with 260 elderly patients (mean ± SD age, 75 ± 3 years; range, 70-85 years).
Results Compared with older patients, young patients had higher body mass indexes (12.2%, P<.001), total cholesterol–high-density lipoprotein ratio (14.6%, P<.01), and triglycerides level (27.2%, P<.01), and a lower high-density lipoprotein cholesterol level (–8.8%, P=.045). Young patients also had higher scores for anxiety and hostility (51.5% and 94.4%, respectively; P<.001 for both), a considerably higher prevalence of anxiety (27.9% vs 13.5%; P<.01) and hostility (12.5% vs 4.6%; P<.01) symptoms, and slightly more depression symptoms (23.1% vs 18.8%) compared with elderly patients. Following cardiac rehabilitation and exercise training, young patients had improvements in body mass index (–1.7%, P<.01), percentage body fat (–4.4%, P<.001), high-density lipoprotein cholesterol level (10.2%, P<.001), high-sensitivity C-reactive protein level (–33.3%, P<.01), peak oxygen consumption (11.3%, P<.001), resting heart rate (–4.5%, P=.01), and resting systolic pressure (–2.3%, P=.049), and marked improvements in scores for depression (–58.5%), anxiety (–46.0%), hostility (–45.7%), somatization (–33.8%), and quality of life (15.8%) (P<.001 for all). Young patients also had greater than 50% to greater than 80% reductions in the prevalence of anxiety (P<.001), hostility (P<.01), and depression (P<.001).
Conclusion These data demonstrate the adverse psychological and CAD risk profiles that are present in young patients with CAD following major CAD events, and are consistent with substantial benefit of formal cardiac rehabilitation and exercise training programs in younger adults.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Conference Paper
Collection: School of Medicine Publications
 
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Created: Mon, 14 Mar 2011, 09:28:49 EST