Dynamics of quality of life indicators and exercise tolerance during outpatient cardiac rehabilitation of patients after coronary revascularization (original article)

Background. The importance of cardiac rehabilitation (CR) is difficult to overestimate. Over the past decades, evidence of the positive impact of CR on the clinical condition and prognosis, the formation of greater adherence to drug treatment, and an improvement in the psychological state of patients after percutaneous coronary interventions (PCI) and coronary artery bypass grafting has accumulated.

Objective. Evaluation of the dynamics of quality of life indicators and exercise tolerance in patients after PCI or coronary artery bypass grafting (CABG) at the outpatient stage of CR using a hybrid CR model.

Methods. The study included 85 patients (66 men and 19 women) 1 month after primary coronary revascularization, who underwent the first and/or second stages of CR and were at the outpatient stage. The patients’ age ranged from 42 to 79 years, mean age – 60.8 ± 7.2 years. Two groups were identified: 1st – 35 (41.2%) patients who underwent PCI with stenting; 2nd – 50 (58.8%) patients after CABG. All patients participated in CR programs in a hybrid format, which included a visit to the clinic in combination with aerobic and combined training at home. Three times (1, 6 and 12 months after surgery) a face-to-face survey using the SF-36 quality of life questionnaire was conducted; an assessment of exercise tolerance using the six-minute walk test (SMWT) was performed twice (1 and 12 months after coronary revascularization).

Results. An improvement in the quality of life of patients after PCI and CABG was shown 6 and 12 months after the intervention, while the type of surgical treatment did not matter, more significant changes occurred during the first half of the CR.

Conclusions. Participation in CR programs contributes to an improvement in quality of life, an increase in exercise tolerance, regardless of the method of coronary revascularization. The use of alternative CR models has shown sufficient effectiveness in relation to the psychological characteristics of the patient’s health, and the physical functional capabilities of the body.