Impact of cardiac rehabilitation on depression and its associated mortality

Milani, Richard V. and Lavie, Carl J. (2007). Impact of cardiac rehabilitation on depression and its associated mortality. In: American Journal of Medicine. 79th Annual Scientific Session of the American Heart Association, Chicago, IL, United States, (799-806). 12-15 November 2006. doi:10.1016/j.amjmed.2007.03.026


Author Milani, Richard V.
Lavie, Carl J.
Title of paper Impact of cardiac rehabilitation on depression and its associated mortality
Conference name 79th Annual Scientific Session of the American Heart Association
Conference location Chicago, IL, United States
Conference dates 12-15 November 2006
Proceedings title American Journal of Medicine   Check publisher's open access policy
Journal name American Journal of Medicine   Check publisher's open access policy
Place of Publication Bridgewater, NJ, United States
Publisher Excerpta Medica
Publication Year 2007
Sub-type Fully published paper
DOI 10.1016/j.amjmed.2007.03.026
ISSN 0002-9343
1555-7162
Volume 120
Issue 9
Start page 799
End page 806
Total pages 7
Language eng
Formatted Abstract/Summary
Purpose

Depression following major cardiac events is associated with higher mortality, but little is known about whether this can be reduced through treatment including cardiac rehabilitation and exercise training. We evaluated the impact of cardiac rehabilitation on depression and its associated mortality in coronary patients.

Patients and Methods

We evaluated 522 consecutive coronary patients (381 men, 141 women; aged 64 ± 10 years) enrolled in cardiac rehabilitation from January 2000 to July 2005 and a control group of 179 patients not completing rehabilitation. Depressive symptoms were assessed by questionnaire at baseline and following rehabilitation, and mortality was evaluated after a mean follow-up of 1296 ± 551 days.

Results

Prevalence of depressive symptoms decreased 63% following rehabilitation, from 17% to 6% (P <.0001). Depressed patients following rehabilitation had an over 4-fold higher mortality than nondepressed patients (22% vs 5%, P = .0004). Depressed patients who completed rehabilitation had a 73% lower mortality (8% vs 30%; P = .0005) compared with control depressed subjects who did not complete rehabilitation. Reductions in depressive symptoms and its associated mortality were related to improvements in fitness; however, similar reductions were noted in those with either modest or marked increases in exercise capacity.

Conclusion

In patients following major coronary events, cardiac rehabilitation is associated with both reductions in depressive symptoms and the excess mortality associated with it. Moreover, only mild improvements in levels of fitness appear to be needed to produce these benefits on depressive symptoms and its associated mortality.
Keyword Coronary Disease
Depression
Exercise
Mortality
Acute Myocardial-infarction
Q-Index Code E1
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, 09:35:37 EST